E-ISSN: 1019-5157
ISSN: 2651-5024
Review
Uric Acid in Intracranial Tumors: A Systematic Review of Diagnostic, Prognostic, and Surgical Relevance
Gustavo Adolfo Villegas-Gomez✉ ,
Raul F. Vega-Alvear ,
Maria Isabel Ocampo-Navia ,
Diego F. Gomez-Amarillo ,
Juan F. Ramón ,
Fernando Hakim ,
Mickaela Echavarría Demichelis ,
Gabriel Vargas Grau ,
Edgar G. Ordóñez-Rubiano
Bogota, Universidad de Los Andes
DOI: 10.5137/1019-5149.JTN.49583-25.3
Article in Press
Corresponding Author:
Gustavo Adolfo Villegas-Gomez (g.villegasg@uniandes.edu.co)
Abstract
Background and Objective:
Uric acid is the end product of purine catabolism and exhibits context-dependent biological effects in relation to oxidative balance and inflammation. Given the prominent metabolic and redox alterations observed in intracranial tumors, circulating and tissue uric acid levels may capture biologically relevant aspects of tumor behavior. This review synthesizes current evidence examining the association between uric acid levels and the occurrence, biological characteristics, and clinical outcomes of intracranial tumors.
Methods:
A structured literature search was performed in PubMed, Embase, CENTRAL, and Web of Science, covering records from database inception through March 18, 2025, in accordance with PRISMA guidance. Studies involving human participants with intracranial tumors were eligible if uric acid was assessed in relation to diagnostic, clinical, or prognostic endpoints.
Results:
Ten studies published between 1994 and 2024 met the inclusion criteria, encompassing gliomas and astrocytomas, pituitary adenomas, craniopharyngiomas, and brain metastases. Longitudinal biobank data demonstrated rising uric acid levels up to eight years prior to glioma diagnosis (Q² = 0.61). In lung cancer cohorts, a serum uric acid threshold of 6.2 mg/dL predicted asymptomatic brain metastases with 83.8% sensitivity and 76% specificity (AUC = 0.674), while levels ≥7.49 mg/dL were independently associated with reduced overall survival. In hormonally active pituitary adenomas, uric acid correlated with insulin-like growth factor 1 and declined following surgical remission. Tissue-based analyses in astrocytomas showed the highest uric acid concentrations within necrotic tumor regions (2.20 ± 0.64 µmol/g). Across several studies, serum uric acid decreased after surgical tumor resection.
Conclusion:
Across heterogeneous tumor types and clinical contexts, uric acid appears to function as a context-sensitive biomarker reflecting tumor metabolism, oxidative stress, and hormonal activity. While the available evidence suggests potential diagnostic and prognostic relevance, prospective longitudinal and mechanistic studies are required to define its role in neuro-oncology more precisely.
Uric acid is the end product of purine catabolism and exhibits context-dependent biological effects in relation to oxidative balance and inflammation. Given the prominent metabolic and redox alterations observed in intracranial tumors, circulating and tissue uric acid levels may capture biologically relevant aspects of tumor behavior. This review synthesizes current evidence examining the association between uric acid levels and the occurrence, biological characteristics, and clinical outcomes of intracranial tumors.
Methods:
A structured literature search was performed in PubMed, Embase, CENTRAL, and Web of Science, covering records from database inception through March 18, 2025, in accordance with PRISMA guidance. Studies involving human participants with intracranial tumors were eligible if uric acid was assessed in relation to diagnostic, clinical, or prognostic endpoints.
Results:
Ten studies published between 1994 and 2024 met the inclusion criteria, encompassing gliomas and astrocytomas, pituitary adenomas, craniopharyngiomas, and brain metastases. Longitudinal biobank data demonstrated rising uric acid levels up to eight years prior to glioma diagnosis (Q² = 0.61). In lung cancer cohorts, a serum uric acid threshold of 6.2 mg/dL predicted asymptomatic brain metastases with 83.8% sensitivity and 76% specificity (AUC = 0.674), while levels ≥7.49 mg/dL were independently associated with reduced overall survival. In hormonally active pituitary adenomas, uric acid correlated with insulin-like growth factor 1 and declined following surgical remission. Tissue-based analyses in astrocytomas showed the highest uric acid concentrations within necrotic tumor regions (2.20 ± 0.64 µmol/g). Across several studies, serum uric acid decreased after surgical tumor resection.
Conclusion:
Across heterogeneous tumor types and clinical contexts, uric acid appears to function as a context-sensitive biomarker reflecting tumor metabolism, oxidative stress, and hormonal activity. While the available evidence suggests potential diagnostic and prognostic relevance, prospective longitudinal and mechanistic studies are required to define its role in neuro-oncology more precisely.
Keywords
Uric acid
Brain neoplasms
Biomarkers
Neurosurgery
Postoperative monitoring.