摘要
目的探讨脑脊液外泌体miR-146a与人脑胶质瘤术后复发的相关性。方法收集2016年5月~2017年5月经术后病理证实的70例脑胶质瘤(低级别胶质瘤31例,高级别胶质瘤39例)和25例颅脑损伤(对照组)的脑脊液,采用PCR检测脑脊液外泌体miR-146a表达水平。胶质瘤病人术后随访1~36个月,记录术后复发情况。结果与对照组(1.00±0.14)相比,脑胶质瘤组脑脊液外泌体miR-146a相对表达量(0.71±0.26)明显降低(P<0.001);高级别胶质瘤脑脊液外泌体miR-146a相对表达量(0.64±0.27)明显低于低级别胶质瘤(0.77±0.24;P<0.05)。随访期间,19例(27.14%)术后复发。多因素logistic回归分析显示,脑脊液外泌体miR-146a表达量低是脑胶质瘤术后复发的独立危险因素(P<0.05)。ROC曲线分析显示,脑脊液外泌体miR-146a表达水平预测脑胶质瘤术后复发的曲线下面积为0.853(95%置信区间0.762~0.944),最佳截断值为0.445,特异度和灵敏度分别为90.2%和63.2%,约登指数为0.534。结论脑胶质瘤病人脑脊液外泌体miR-146a表达普遍降低,而且胶质瘤病理级别越高,降低越明显;脑脊液外泌体miR-146a表达水平对预测术后复发具有一定的参考价值。
Objective To explore the correlation between the cerebrospinal fluid(CSF)level of exosomal miR-146a and the postoperative recurrence of glioma.Methods The levels of exosomal miR-146a were detected in the CSF obtained from 70 glioma patients(31 low-grade and 39 high-grade gliomas)who underwent surgery from May 2016 to May 2017 and from 25 patients with traumatic brain injury(control group)using the PCR.All the glioma patients were followed up from 1 to 36 months.Results The relative expression level of CSF exosomal miR-146a of glioma group was significantly lower than that of control group(P<0.001).The relative expression level of CSF exosomal miR-146a of high-grade gliomas was significantly lower than that of low-grade gliomas(P<0.05).During the follow-up,19 patients(27.14%)had the postoperative recurrence of tumors.Multivariate logistic regression analysis showed down-expression of CSF exosomal miR-146a was an independent risk factor for the postoperative recurrence of glioma patients(P<0.05).ROC curve showed that:the area under curve of the expression level of CSF exosomal miR-146a to predict the postoperative recurrence of glioma patients was 0.853(95%CI 0.762~0.944);the best cut-off value was 0.445,the specificity and sensitivity were 90.2%and 63.2%,respectively;the Youden index was 0.534.Conclusions The expression of CSF miR-146a of patients with glioma is generally down-regulated,and the higher the pathological grade of glioma,the more obvious the decrease of the level of CSF miR-146a.The expression level of CSF miR-146a has certain value for predicting the postoperative recurrence of glioma patients.
作者
田艳
魏可欣
张向宁
TIAN Yan;WEI Ke-xin;ZHANG Xiang-ning(Department of Neurosurgery,The 82nd Group Military Hospital,PLA,Baoding 07l000,China;Department of Neurosurgery,Baoding No.1 Hospital,Baoding 07l000,China)
出处
《中国临床神经外科杂志》
2021年第4期250-253,共4页
Chinese Journal of Clinical Neurosurgery
