尿酸 (UA) 在恶性肿瘤患者中起着抗氧化剂和促氧化剂的双重作用，然而血清UA与恶性肿瘤的关系目前尚不清楚。本研究旨在调查免疫疗法前血清尿酸水平对原发性肝癌 (PLC) 免疫疗法疗效的预后价值，以期为优化综合治疗方案提供基础。回顾性收集2019年1月至2022年6月在赣南医学院附属第一医院接受免疫疗法的PLC患者。使用卡方检验分析PLC患者血清UA水平的差异，血清UA水平与PLC患者临床特征的相关性，并使用Kaplan-Meier分析估计生存率。进一步评估UA浓度的预后意义，进行单因素和多因素Cox回归分析。本研究共纳入99例患者。中位随访时间为7个月 (范围: 1-29个月)，截至2022年12月31日，99例PLC患者中有76例 (76.8%) 死亡。血清UA浓度范围为105至670 μmol/l，中位数为269 μmol/l。结果显示PLC患者的血清UA水平高于健康受试者 (P < 0.001)。亚组分析后发现，只有男性肝癌患者的血清UA水平高于健康男性 (P = 0.001)。Kaplan-Meier分析结果显示较高的UA水平与较差的总生存率 (OS) 相关 (P = 0.005)。在单因素分析中，血清UA水平升高的患者的OS率明显低于阈值 (风险比 [HR]: 3.191，95%置信区间 [CI]: 1.456-6.993，P = 0.004)，高和低血清UA组的中位生存时间分别为151和312天。多因素分析结果显示UA水平是PLC患者免疫疗法疗效的独立预后因素 (HR: 3.131，95% CI: 1.766-5.553，P < 0.001)。血清UA水平是预测PLC患者接受免疫疗法的预后可靠生物标志物，并可能为这些患者的个体化治疗提供基础。动态监测血清UA水平可能弥补目前肝癌分期系统的不足。© 2023. 作者等。

Uric acid (UA) plays a dual role as an antioxidant and a prooxidant in patients with malignant tumors; however, the relationship between serum UA and malignancy is currently unclear. This study aims to investigate the prognostic value of serum uric acid level before immunotherapy on the efficacy of primary liver cancer (PLC) immunotherapy, which might provide a basis for optimizing the comprehensive treatment scheme.Patients with PLC who were admitted to the First Affiliated Hospital of Gannan Medical College from January 2019 to June 2022 and underwent immunotherapy were collected retrospectively. The difference between serum UA levels in patients with PLC, the correlation between serum UA levels, and the clinical characteristics of patients with PLC were analyzed using the chi-square test, and the survival was estimated using the Kaplan-Meier analysis. To further assess the prognostic significance of UA concentrations, univariate and multivariate Cox regression analyses were performed.Ninety-nine patients were included in this study cohort. The median follow-up was 7 months (range: 1-29 months), and 76 (76.8%) of the 99 patients with PLC died as of December 31, 2022. Serum UA concentrations ranged from 105 to 670 μmol/l, with a median of 269 μmol/l. The results showed that the serum UA level of patients with PLC was higher than that of healthy subjects (P < 0.001). After subgroup analyses, only male patients with liver cancer had higher serum UA levels than healthy men (P = 0.001). The results of the Kaplan-Meier analysis showed that higher UA levels were associated with poor overall survival (OS) (P = 0.005). In univariate analysis, the OS rate of patients with elevated serum UA levels was significantly lower than the cut-off value (hazard ratio [HR]: 3.191, 95% confidence interval [CI]: 1.456-6.993, P = 0.004), with a median survival time of 151 and 312 days in the high and low serum UA groups, respectively. The results of multivariate analysis showed that the UA level was an independent prognostic factor for immunotherapy in patients with PLC (HR: 3.131, 95% CI: 1.766-5.553, P < 0.001).The serum UA level is a reliable biomarker for predicting the prognosis of patients undergoing immunotherapy for PLC, and might provide a basis for the individualized treatment of these patients. Dynamic monitoring of the serum UA level may compensate for the deficiency of the current liver cancer staging system.© 2023. The Author(s).