目的 探讨血尿酸水平对老年胃癌患者预后的评估作用。 方法 选择 2017 年 2 月至 2022 年 2 月溧阳市人民医院老 年胃癌患者共 100 例,依照患者的预后情况将其分为良好组(60 例)、欠佳组(40 例),收集所有患者的病例资料进行回顾性分 析。 对比两组一般资料[年龄、性别、体质指数、病程、肿瘤家族史、吸烟史、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、癌胚 抗原(CEA)、糖类抗原 19-9(CA19-9)、血尿酸水平、肿瘤直径、肿瘤分期、放化疗史以及手术治疗史]。 分析影响老年胃癌患 者预后的因素。 根据血尿酸结果,将患者分为低血尿酸组(≤420 μmol / L)与高血尿酸组(>420 μmol / L)。 通过 Kaplan-Meier 生存分析法比较不同血尿酸水平患者的生存率。 并对其进行 Logistic 回归分析、Spearman 分析以及受试者操作特征曲线 (ROC 曲线)分析。 结果 两组患者年龄、性别、体质指数、病程、肿瘤家族史、吸烟史、LDL、HDL、肿瘤直径、肿瘤分期、放化疗 史、手术治疗史均无明显差异(P>0. 05),在 CEA、CA19-9、血尿酸水平差异有统计学意义(P<0. 05)。 Kaplan-Meier 生存分析 法分析结果发现,高尿酸组老年胃癌患者死亡率较高,且与低尿酸组患者生存结局差异有统计学意义(P<0. 05)。 多因素 Logistic 回归分析显示,血尿酸水平>420 μmol / L 是老年胃癌患者预后的独立危险因素(OR = 2. 177,P<0. 05)。 Spearman 分析显 示,血尿酸水平与老年胃癌患者预后呈中度线性相关(r = 0. 612,P<0. 05);ROC 曲线分析显示,血尿酸水平对老年胃癌患者预 后具有一定评估价值(AUC= 0. 877,敏感度= 86. 76%,特异度 = 75. 23%,P<0. 05)。 结论 血尿酸水平与老年胃癌患者的预后 密切相关,其水平过高(>420 μmol / L)可能预示着老年胃癌患者预后不佳,临床上可针对血尿酸水平过高的老年胃癌患者制 定更全面的诊疗计划。

Objective This study aims to examine the potential of blood uric acid concentration as a prognostic indicator for elderly patients with gastric cancer. Method 100 cases of elderly patients with gastric cancer were selected from February 2017 to February 2022 in our hospital. The patients were divided into two groups based on their prognosis a good group 60 cases and a poor group 40 cases . All the patients' case data were collected and analyzed retrospectively. The two groups were compared in terms of their general data including age gender body mass index disease duration family history of tumor smoking history low-density lipoprotein LDL high-density lipoprotein HDL carcinoembryonic antigen CEA carbohydrate antigen 19- 9 CA19- 9 blood uric acid concentration tumor diameter tumor stage history of radiotherapy and history of surgical treatment. The impact of various factors on the prognosis of elderly patients with gastric cancer was evaluated. The patients were classified into two groups based on their blood uric acid levels with the low uric acid group comprising those with lower levels and the high uric acid group comprising those with higher levels. The survival rates of patients with different uric acid levels were then compared using Kaplan - Meier survival analysis. Additionally logistic regression analysis Spearman analysis and ROC curve analysis were conducted. Result There were no significant differences between the two groups in age gender body mass index disease duration family history of cancer smoking history LDL HDL tumor diameter tumor stage history of radiotherapy or chemotherapy or history of surgical treatment P > 0. 05 . However statistically significant differences were observed in CEA CA19 - 9 and serum uric acid levels P < 0. 05 . Kaplan-Meier survival analysis revealed a higher mortality rate in elderly gastric cancer patients with elevated serum uric acid levels with statistically significant differences in survival outcomes compared to the low uric acid group P< 0. 05 . Multivariate logistic regression analysis indicated that serum uric acid levels >420 μmol / L constituted an independent risk factor for prognosis in elderly gastric cancer patients OR = 2. 177 P<0. 05 . Spearman's analysis demonstrated a moderate linear correlation between serum uric acid levels and prognosis in elderly gastric cancer patients r = 0. 612 P < 0. 05 . ROC curve analysis demonstrated that serum uric acid levels possess certain predictive value for prognosis in elderly gastric cancer patients AUC = 0. 877 sensitivity = 86. 76% specificity = 75. 23% P < 0. 05 . Conclusion Serum uric acid levels are closely associated with the prognosis of elderly gastric cancer patients with a uniform cutoff value of 420 μmol / L. Elevated levels may indicate a poor prognosis for elderly gastric cancer patients and clinically more comprehensive treatment plans can be developed for elderly gastric cancer patients with elevated serum uric acid levels.