Correlation between serum cystatin C and uric acid levels and prognosis of small cell lung cancer / 国际肿瘤学杂志

ABSTRACT

Objective:To explore the effects of serum cystatin C (Cys C) and uric acid (UA) concentrations before treatment on the prognosis of small cell lung cancer (SCLC) patients.Methods:A total of 196 patients diagnosed with SCLC in Affiliated Hospital of Qingdao University from April 2015 to December 2018 were selected, and hematological indicators such as serum Cys C and UA before treatment were collected. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of Cys C and UA. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for univariate and multivariate analysis.Results:The optimal cut-off values of serum Cys C and UA before treatment were 0.775 mg/L and 296.45 μmol/L, respectively. Survival analysis showed that with the optimal cut-off value, the median progression-free survival (PFS) of patients with high concentrations of serum Cys C and UA (5.49 months vs. 8.57 months, χ2=35.943, P<0.001; 6.67 months vs. 8.20 months, χ2=8.047, P=0.005) and overall survival (OS) (13.37 months vs. 23.95 months, χ2=21.355, P<0.001; 14.13 months vs. 20.97 months, χ2=11.333, P=0.001) were shorter than those of patients with low concentrations. Univariate analysis showed that factors related to PFS were smoking history ( HR=0.707, 95% CI 0.518-0.965, P=0.029), staging ( HR=1.776, 95% CI 1.329-2.373, P<0.001), first-line medication ( HR=1.596, 95% CI 1.072-2.376, P=0.021), chest radiotherapy ( HR=2.407, 95% CI 1.803-3.214, P<0.001), Cys C ( HR=3.602, 95% CI 1.716-7.561, P=0.001), UA ( HR=1.002, 95% CI 1.000-1.003, P=0.036), and alkaline phosphatase ( HR=1.010, 95% CI 1.004-1.016, P=0.001); factors related to OS included smoking history ( HR=0.577, 95% CI 0.382-0.870, P=0.009), staging ( HR=1.846, 95% CI 1.295-2.630, P=0.001), chest radiotherapy ( HR=2.041, 95% CI 1.426-2.921, P<0.001), Cys C ( HR=9.506, 95% CI 3.278-27.564, P<0.001) and UA ( HR=1.003, 95% CI 1.001-1.005, P=0.006). Multivariate analysis showed that chest radiotherapy ( HR=2.553, 95% CI 1.774-3.672, P<0.001), Cys C ( HR=4.538, 95% CI 1.875-10.982, P=0.001) and alkaline phosphatase ( HR=1.011, 95% CI 1.005-1.018, P=0.001) were independent prognostic factors for PFS; Cys C ( HR=9.028, 95% CI 2.680-30.413, P<0.001) was an independent prognostic factor for OS. Conclusion:Both serum Cys C and UA concentrations before treatment in SCLC patients have a certain relationship with the prognosis of the patients. Those with elevated concentrations have shorter PFS and OS and poor prognosis. The high concentration of serum Cys C before treatment may indicate a rapid progression of the disease and a short survival time. It is necessary to pay attention to disease progression and recurrence.