Analysis Of Serum Uric Acid And Neutrophil-lymphocyte Ratio In The Prognosis Of Non-small Cell Lung Cancer

Background and Objective:Non-small cell lung cancer(NSCLC)is one of the most common malignant tumors,mostly related to environmental and genetic factors.In 2016,malignant tumor has become the second leading cause of death in the world,second only to cardiovascular disease.The incidence and mortality of lung cancer is the highest in China.In 2015,the annual incidence of lung cancer in China is as high as 730000,and the number of deaths is as high as 610000.At present,the treatment of lung cancer includes surgery,radiotherapy,chemotherapy and so on.Although the survival time of NSCLC was improved by certain treatment,the overall survival rate of NSCLC was lower.At present,there are no specific tumor markers in non-small cell lung cancer,and there are few studies on prognosis survival time.Scientists all over the world are also trying to find the effective independent prognostic factors of non-small cell lung cancer.The aim of this study was to investigate the pathological and clinical relationship between serum uric acid Uric and neutrophil to lymphocyte ratio in patients with NSCLC,and to find out effective and simple prognostic predictors of NSCLC.This provides clinical evidence for evaluating the efficacy of lung cancer treatment and monitoring prognosis.Methods :(1)A retrospective analysis of 343 patients with non-small cell lung cancer(NSCLC)from January 2014 to December 2015 was performed in cardiothoracic surgery of the first affiliated Hospital of Nanchang University.The data included gender,age,smoking history and routine blood test within one week before operation: blood serum uric acid(SUA),leukocyte(WBC),neutrophils(NEU),and neutrophils.LYM,neutrophils-lymphocyte(NLR);tumor size diameter,tumor histological classification,tumor site,and lung cancer pTNM staging.Telephone follow-up to understand postoperative tumor recurrence and postoperative survival.Patients were included in the criteria: patients received radical surgery for lung cancer and had a week before operation.The patient must have postoperative pathological results,and the result must be non-small cell lung cancer.The exclusion criteria include: preoperative radiotherapy and chemotherapywere used before surgery;the postoperative pathology was small cell lung cancer or preoperative puncture results for small cell lung cancer patients;patients with preoperative bleeding data were not complete.(2)The receiver operating characteristic curve(ROC curve)was created to determine the preoperative serum uric acid and the optimal cutoff value of the neutrophil lymphocyte ratio.The continuous variable loading was replaced by a classification variable,the single factor analysis was carried out by Kaplan-Meier method and the survival curve was drawn.The single factor survival between the group and the group was found.Analysis was conducted by log-rank.Multivariate regression analysis was conducted using Cox regression model.(3)SPSS18.0 software was used for statistical analysis.P=0.05 was the test standard.Results:(1)Relationship between SUA and NSCLCThe operating characteristic curve of SUA was depicted,and the truncation value of SUA was found according to the Youden index.According to the truncation value,SUA was divided into high SUA group and low SUA group.It was found that there was significant difference in pTNM staging between high and low SUA groups(P <0.05).(2)Relationship between NLR and NSCLCThe subjects' characteristic curve of NLR was established and the truncated value of NLR was found on the basis of the Jordan index(3.55).According to the truncation value,the NLR was divided into high NLR group and low NLR group.The gender,pathological type,tumor location,T staging,and pTNM staging were statistically significant,P values were gender(0.005),pathological type(0.003),tumor location(0.018),T staging(<0.001)and pTNM(0.001).(3)Single factor analysis of OSBy univariate analysis of all the data in the study,it was found that T staging,N staging,pTNM staging,pathological types,tumor location,SUA,and NLR were all associated with OS.The P values were T stage(<0.001),N stage(<0.001),pTNM stage(<0.001),pathological type(0.003),tumor location(0.001)and NLR(<0.001).(4)Multi-factor analysis of OSBy multivariate analysis of all OS-related items in single factor,it was found that the tumor location,pTNM staging and SUA were all correlated with OS.P value was the tumor location(0.002),pTNM stage(0.012),NLR(0.044)and SUA(0.026).According to the analysis of the results,the survival time around the tumor location in lung cancer patients was longer than that in the central group;the higher the pTNM stage of lung cancer patients was,the worse the prognosis of the patients was,and the survival time of low and low NLR group was higher than that of high NLR group.The survival time of high SUA group was higher than that of low SUA group.Conclusion:(1)The median survival time of patients with high SUA is longer than that of patients with low SUA.(2)The median survival time of patients with low NLR is longer than that of patients with high NLR.(3)The important test index of postoperative survival rate.