胰腺癌患者血清尿酸、肌酐水平检测及尿酸/肌酐比值的临床意义

目的 研究血生化指标尿酸(UA)、肌酐(Cr)水平及尿酸/肌酐比值(UA/Cr比值)在胰腺癌(pancreatic ductal adenocarcinoma,PDAC)中的水平,了解其与临床病理特征的关系,并探讨其可能的机制。方法 收集2017年5月～2018年8月南京医科大学第一附属医院胰胆中心收治并经组织病理确诊的282例胰腺癌患者和58例胰腺良性肿瘤患者。并收集同期间200例健康体检者。采用Beckman Coulter AU5800生化分析仪检测血清UA和Cr水平,同时分析UA,Cr水平和UA/Cr比值与胰腺癌临床病理特征之间的关系。结果 血清UA,Cr水平及UA/Cr比值在胰腺癌组与胰腺良性肿瘤组、正常对照组比较,差异均有统计学意义(F或Z=-6.781～11.175,均P<0.05),而UA和UA/Cr比值在良性肿瘤组和正常对照组之间比较,差异均无统计学意义(F或Z=-1.888～11.559,均P>0.05),Cr水平在良性肿瘤组和正常对照组之间比较,差异有统计学意义(F=2.121,P<0.05)。血清UA,Cr水平和UA/Cr比值与胰腺癌患者性别、肿瘤部位有关(T或Z=-9.178～17.986,均P<0.05),UA/Cr比值还与胰腺癌患者年龄有关(Z=-2.294,P<0.05)。三者均与肿瘤最大径、临床分期、病理分级、淋巴结转移及远处转移无关(T或Z=-1.452～2.214,均P>0.05)。结论 UA水平在胰腺癌患者中显著降低,机体抗氧化能力在肿瘤发生中作用很大,UA/Cr比值能更好地反映老年胰腺癌患者体内的抗氧化能力。但两者均不能作为独立的指标对胰腺癌进行早期检测和诊断。

Clinical Significance of Serum Uric Acid,Creatinineand Uric Acid/Creatinine Ratio in Pancreatic Ductal Adenocarcinoma

Objective To evaluate the level of serum uricacid(UA),creatinine(Cr)and uric acid/ creatinine ratio(UA/Cr ratio)in pancreatic ductal adenocarcinoma(PDAC)and explore its possible mechanism.Methods 282 cases of PDAC and 58 cases of benign pancreatic tumor diagnosed in histopathology from May 2017 to April 2018 in the First Affiliated Hospital of Nanjing Medical University of pancreatic biliary center were studied.Meanwhile,200 cases of healthy people at the same period were also studied.Serum UA and creatinine(Cr)were detected with Beckman Coulter AU5800 biochemical analyzer,and then the relationship among UA,Cr,UA/Cr ratio and the clinicopathological features was analyzed.Results The level of serumUA,Cr and UA/Cr ratio in PDAC group were significantly lower than the benign tumor group and the control group(F or Z=-6.781～11.175,all P<0.05).Meanwhile,the level of UA and UA/Cr ratio had no significiances betweenbenign tumor group and control group(F or Z=-1.888～11.559,all P>0.05),but the level of Cr was opposite(F=2.121,P<0.05).UA,Cr andUA/Cr ratio were associated with sex,tumor position(F or Z=-9.178～ 17.986,all P<0.05),but had nothing to do with age,tumor size,clinicalstage,pathology grade,lymphatic metastasis and distant metastasis(F or Z=-1.136～2.214,all P>0.05).Meanwhile,UA/Cr ratio was also related to the age(Z=-2.294,P<0.05).Conclusion The levelof UA was significient reduced in PDAC which showed great importance of its antioxidant capacity in tumorigenesis.UA/Cr ratio can reflect the antioxidant capacity of elderly patients better.However,neither of them can be used as independent indicators for early detection and diagnosis of PDAC.