Prognostic Nomogram on Clinicopathologic Features and Serum Uric Acid for Precancerous Lesions and Gastric Cancer

doi:10.21203/rs.3.rs-748722/v1

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Prognostic Nomogram on Clinicopathologic Features and Serum Uric Acid for Precancerous Lesions and Gastric Cancer

https://doi.org/10.21203/rs.3.rs-748722/v1

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The relationship between Uric acid (UA) and malignant tumor are still confusing. Gastric cancer(GC) is recognized to be closely related to Helicobacter pylori (H. pylori) infection, early diagnosis rate is very low. In this study, we aimed to investigate the relationship between H. pylori and hyperuricemia (HUA), and evaluate the predictive value of serum uric acid (SUA) in gastric precancerous lesion (GPL) and gastric cancer (GC). This retrospective study included 486 patients who underwent gastroscopy (155 controls, 272 GPL, 59 GC patients). The risk factors for GPL and GC were identified by multiple logistic regression analysis and nomogram was constructed to evaluate the ability of SUA to predict the risk of these diseases based on SUA score. We found that in healthy controls, HUA is positively correlated with H. Pylori (+). SUA was an independent risk factor for GPL and GC. Verification shows that the nomogram was better fitted for GC than for GPL. In conclusion, our study established nomogram based on SUA to predict the risk of GPL and GC, suggested that the incidence of GPL and GC is higher in H. pylori (+) HUA patients, so early intervention and vigilance should be raised.

Cancer Biology

Oncology

Endocrinology & Metabolism

Gastroenterology & Hepatology

Uric acid

Helicobacter pylori

Gastric precancerous lesion

Gastric cancer

Predictive value

Table 1. Demographic and Clinical Characteristics of Patients

Characteristics	N=486
Characteristics	Healthy (n = 155)	Precancerous lesion (n = 272)	p	Gastric cancer (n = 59)	p
Age, n (%)			0.039		0.027
< 31	3(1.9%)	9(3.3%)		0(0%)
31 - 50	36(23.2%)	41(15.1%)		4(6.8%)
50 - 70	58(37.4%)	116(42.6%)		27(45.8%)
> 70	58(37.4%)	101(37.1%)		28 (47.5%)
Gender, n (%)			0.023		< 0.001
Male	61(39.4%)	138(50.7%)		40(67.8%)
Female	94(60.6%)	134(49.3%)		19(32.2%)
BMI, n (%)			< 0.001		< 0.001
<18.5kg/m^2	2(2.3%)	5(1.8%)		1(1.7%)
18.5-24kg/m^2	88(56.8%)	95(34.9%)		18(30.5%)
24-28kg/m^2	56(36.1%)	121(44.5%)		27(45.8%)
>28kg/m^2	9(5.8%)	51(18.8%)		13(22.0%)
TG, n (%)			0.162		0.188
>=2.3mmol/L	27(17.4%)	34(12.5%)		15(25.4%)
<2.3mmol/L	128(82.6%)	238(87.5%)		44(74.6%)
TC, n (%)			0.072		0.264
>=6.2mmol/L	9(5.8%)	30(11.0%)		6(10.2%)
<6.2mmol/L	146(94.2%)	242(89.0%)		53(89.8%)
HDL-C, n (%)			0.073		0.651
<=1mmol/L	36(23.2%)	44(12.9%)		12(20.3%)
>1mmol/L	119(76.8%)	228(87.1%)		47(79.7%)
LDL-C, n (%)			0.008		0.003
>=4.1mmol/L	10(6.5%)	41(15.1%)		12(22.3%)
<4.1mmol/L	145(93.5%)	231(84.9%)		47(79.7%）
*H. pylori*			<0.001		<0.001
(+)	12(7.7%)	58(21.3%)		17(28.8%)
(-)	143(92.3%)	214(78.7%)		42(71.2%)
SUA, n (%)			<0.001		<0.001
Q1	58(37.4%)	35(12.9%)		5(8.5%)
Q2	58(37.4%)	42(15.4%)		7(11.9%)
Q3	22(14.2%)	90 (33.1%)		23 (39.0%)
Q4	17(11.0%)	105 (38.6%)		24(40.7%)

</tbody>

a. Data are number (percent)

b. Abbreviations: BMI, body mass index; TG, Triglycerides; TC, Total cholesterol, HDL, high-density lipoprotein; LDL low-density lipoprotein; SUA, serum uric acid

Table 2. Relationship between H. pylori Infection and HUA

Healthy（n = 155）			R	P
	*H. pylori* (+) (n = 12)	*H. pylori* (-) (n = 143)	0.207	0.029
With HUA	4(33.3%)	13(9.1%）
Without HUA	8(66.7%)	130(90.3%）

a. Data are number (percent)

b. Abbreviations: HUA, hyperuricemia; H. pylori, Helicobacter Pylori,

c. All theoretical Numbers T ≥ 5 and total sample size n ≥ 40 were tested by Pearson chi-square.; If the theoretical number T is less than 5 but T is ≥1 and n is ≥ 40, chi-square test is conducted with continuity correction; If there is a theoretical number T < 1 or n < 40, use Fisher's test.

Table 3. H. pylori Infection Complicated with HUA in The Three Groups

*H. pylori* (+)
	Healthy (n = 12)	Precancerous Lesion (n = 58)	p	Gastric cancer (n = 17)	p
With HUA	4(33.3%)	27(46.6%)	0.021	8(47.1%)	0.043
Without HUA	8(66.7%)	31(53.4%)		9(52.9%)
a. Data are number (percent) b. Abbreviations: HUA, hyperuricemia; H. pylori, Helicobacter Pylori, c. All theoretical Numbers T ≥ 5 and total sample size n ≥ 40 were tested by Pearson chi-square.; If the theoretical number T is less than 5 but T is ≥1 and n is ≥ 40, chi-square test is conducted with continuity correction; If there is a theoretical number T < 1 or n < 40, use Fisher's test.

Table 4. Multiple Regression Analysis of Variables about Precancerous Gastric Lesions and Gastric Cancer

Variable	Precancerous gastric lesions		Gastric cancer
Variable	p	OR (95%CI)		p	OR (95%CI)
Gender	0.003	2.054(1.288 - 3.277)		0.288	1.555(0.689 - 3.508)
Age	0.161	1.224(0.922 - 1.625)		0.020	1.826(1.102 - 3.026)
LDL-C	0.138	1.846(0.822 - 4.145)		0.066	2.758 (0.936 - 8.122)
BMI	0.028	1.269(1.026 - 1.570)		0.054	1.377(0.995 - 1.906)
*H. pylori*	0.011	2.502(1.237 - 5.061)		0.011	3.434(1.324 - 8.907)
SUA	< 0.001	2.275(1.809 - 2.860)		< 0.001	2.493(1.668 - 3.726)

</tbody>

a. The reference category: group ^ Healthy

b. Abbreviations: 95% CI, 95% confidence interval; OR, odd ratio

Table 5. The C-index of The Nomogram of Precancerous Gastric Lesions and Gastric Cancer

Group	C-index	SD	Z-Value	p	n
Precancerous gastric lesions	0.781	0.050	11.30	< 0.001	427
Gastric Cancer	0.835	0.059	11.42	< 0.001	214

No competing interests reported.

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Prognostic Nomogram on Clinicopathologic Features and Serum Uric Acid for Precancerous Lesions and Gastric Cancer

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