目的:探讨小细胞肺癌(SCLC)患者初治前血清胱抑素C与尿酸浓度对预后的影响。方法:选取2015年4月至2018年12月在青岛大学附属医院诊断为SCLC的患者196例，收集患者治疗前血清胱抑素C与尿酸等血液学指标。通过受试者工作特征(ROC)曲线确定胱抑素C与尿酸的最佳临界值。用Kaplan-Meier方法进行生存分析。采用Cox比例风险模型进行单因素、多因素分析。结果:患者治疗前血清胱抑素C与尿酸的最佳临界值分别为0.775 mg/L和296.45 μmol/L。生存分析显示，以最佳临界值为界，血清胱抑素C、尿酸浓度高的患者中位无进展生存时间(PFS)(5.49个月n vs. 8.57个月，n χ2＝35.943，n P<0.001；6.67个月n vs. 8.20个月，n χ2＝8.047，n P＝0.005)和总生存时间(OS)(13.37个月n vs. 23.95个月，n χ2＝21.355，n P<0.001；14.13个月n vs. 20.97个月，n χ2＝11.333，n P＝0.001)均较浓度低的患者缩短。单因素分析显示，与PFS相关的因素有吸烟史(n HR＝0.707，95%n CI为0.518～0.965，n P＝0.029)、分期(n HR＝1.776，95%n CI为1.329～2.373，n P<0.001)、一线化疗用药(n HR＝1.596，95%n CI为1.072～2.376，n P＝0.021)、胸部放疗(n HR＝2.407，95%n CI为1.803～3.214，n P<0.001)、胱抑素C(n HR＝3.602，95%n CI为1.716～7.561，n P＝0.001)、尿酸(n HR＝1.002，95%n CI为1.000～1.003，n P＝0.036)及碱性磷酸酶(n HR＝1.010，95%n CI为1.004～1.016，n P＝0.001)；与OS相关的因素有吸烟史(n HR＝0.577，95%n CI为0.382～0.870，n P＝0.009)、分期(n HR＝1.846，95%n CI为1.295～2.630，n P＝0.001)、胸部放疗(n HR＝2.041，95%n CI为1.426～2.921，n P<0.001)、胱抑素C(n HR＝9.506，95%n CI为3.278～27.564，n P<0.001)及尿酸(n HR＝1.003，95%n CI为1.001～1.005，n P＝0.006)。多因素分析显示，胸部放疗(n HR＝2.553，95%n CI为1.774～3.672，n P<0.001)、胱抑素C(n HR＝4.538，95%n CI为1.875～10.982，n P＝0.001)及碱性磷酸酶(n HR＝1.011，95%n CI为1.005～1.018，n P＝0.001)是PFS的独立预后因素；胱抑素C(n HR＝9.028，95%n CI为2.680～30.413，n P<0.001)是OS的独立预后因素。n 结论:SCLC患者治疗前血清胱抑素C与尿酸浓度均与患者预后有一定关系，浓度升高者PFS和OS缩短，预后差。治疗前血清胱抑素C浓度高可能提示患者病情进展快、生存时间较短，需注意疾病的进展与复发。“,”Objective:To explore the effects of serum cystatin C (Cys C) and uric acid (UA) concentrations before treatment on the prognosis of small cell lung cancer (SCLC) patients.Methods:A total of 196 patients diagnosed with SCLC in Affiliated Hospital of Qingdao University from April 2015 to December 2018 were selected, and hematological indicators such as serum Cys C and UA before treatment were collected. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of Cys C and UA. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for univariate and multivariate analysis.Results:The optimal cut-off values of serum Cys C and UA before treatment were 0.775 mg/L and 296.45 μmol/L, respectively. Survival analysis showed that with the optimal cut-off value, the median progression-free survival (PFS) of patients with high concentrations of serum Cys C and UA (5.49 months n vs. 8.57 months, n χ2=35.943, n P<0.001; 6.67 monthsn vs. 8.20 months, n χ2=8.047, n P=0.005) and overall survival (OS) (13.37 months n vs. 23.95 months, n χ2=21.355, n P<0.001; 14.13 monthsn vs. 20.97 months, n χ2=11.333, n P=0.001) were shorter than those of patients with low concentrations. Univariate analysis showed that factors related to PFS were smoking history (n HR=0.707, 95%n CI: 0.518-0.965, n P=0.029), staging (n HR=1.776, 95%n CI: 1.329-2.373, n P<0.001), first-line medication (n HR=1.596, 95%n CI: 1.072-2.376, n P=0.021), chest radiotherapy (n HR=2.407, 95%n CI: 1.803-3.214, n P<0.001), Cys C (n HR=3.602, 95%n CI: 1.716-7.561, n P=0.001), UA (n HR=1.002, 95%n CI: 1.000-1.003, n P=0.036), and alkaline phosphatase (n HR=1.010, 95%n CI: 1.004-1.016, n P=0.001); factors related to OS included smoking history (n HR=0.577, 95%n CI: 0.382-0.870, n P=0.009), staging (n HR=1.846, 95%n CI: 1.295-2.630, n P=0.001), chest radiotherapy (n HR=2.041, 95%n CI: 1.426-2.921, n P<0.001), Cys C (n HR=9.506, 95%n CI: 3.278-27.564, n P<0.001) and UA (n HR=1.003, 95%n CI: 1.001-1.005, n P=0.006). Multivariate analysis showed that chest radiotherapy (n HR=2.553, 95%n CI: 1.774-3.672, n P<0.001), Cys C (n HR=4.538, 95%n CI: 1.875-10.982, n P=0.001) and alkaline phosphatase (n HR=1.011, 95%n CI: 1.005-1.018, n P=0.001) were independent prognostic factors for PFS; Cys C (n HR=9.028, 95%n CI: 2.680-30.413, n P<0.001) was an independent prognostic factor for OS.n Conclusion:Both serum Cys C and UA concentrations before treatment in SCLC patients have a certain relationship with the prognosis of the patients. Those with elevated concentrations have shorter PFS and OS and poor prognosis. The high concentration of serum Cys C before treatment may indicate a rapid progression of the disease and a short survival time. It is necessary to pay attention to disease progression and recurrence.