摘要
目的探究血清髓鞘碱性蛋白(MBP)、癌胚抗原(CEA)及预后营养指数(PNI)水平与脑胶质瘤肿瘤恶性程度及术后复发的相关性。方法选取2019年7月至2023年7月在邢台市中心医院进行手术治疗的脑胶质瘤患者126例,根据术后病理WHO中枢神经系统肿瘤分类分为低级别组(Ⅰ、Ⅱ级)和高级别组(Ⅲ、Ⅳ级),术后随访1年,根据复发情况分为复发组和未复发组,比较组间临床资料及血清MBP、CEA及PNI水平差异,Spearman相关系数分析上述指标与WHO分级的相关性,受试者工作特征(ROC)曲线分析其对脑胶质瘤术后1年复发的预测价值,二元Logistic回归分析脑胶质瘤术后复发的危险因素。结果术后病理结果显示,126例脑胶质瘤患者中,低级别组45例(35.71%),高级别组81例(64.29%),两组年龄>60岁患者占比、血清MBP、CEA、PNI水平差异均有统计学意义(P<0.05);脑胶质瘤患者血清MBP、CEA与WHO分级呈正相关(P<0.05),PNI水平与WHO分级呈负相关(P<0.05);126例脑胶质瘤术后患者中有56例在1年内复发(44.44%)。与未复发组比较,复发组年龄>60岁、肿瘤直径>5 cm患者占比、血清MBP、CEA均升高(P<0.05),PNI水平降低(P<0.05);血清MBP、CEA及PNI水平单独预测脑胶质瘤术后1年复发的AUC分别为0.819、0.868、0.749,联合预测的AUC为0.892(P<0.05);年龄、肿瘤直径、血清MBP、CEA及PNI水平均为脑胶质瘤术后1年复发的危险因素(P<0.05)。结论血清MBP、CEA及PNI水平与脑胶质瘤的恶性程度及术后复发密切相关,三者联合预测术后1年复发的效能优于单一指标,可应用于临床辅助评估脑胶质瘤复发风险,为治疗方案的优化提供参考。
Objective To investigate the correlation between serum myelin basic protein(MBP),carcinoembryonic antigen(CEA)and prognostic nutritional index(PNI)and the tumor malignancy degree and postoperative recurrence in patients with glioma.Methods 126 patients with glioma who received surgical treatment in our hospital from July 2019 to July 2023 were selected.According to the postoperative pathological WHO central nervous system tumor grading,they were divided into low-grade group(grades Ⅰ and Ⅱ)and highgrade group(grades Ⅲ and Ⅳ).At 1 year of follow-up after surgery,the patients were classified into recurrence group and non-recurrence group based on the recurrence status.The differences in clinical data and serum MBP,CEA and PNI levels were compared between groups.Spearman correlation coefficient was used to analyze the correlation between the above indicators and WHO grading.Receiver operating characteristic(ROC)curve was applied to analyze its predictive value on recurrence at 1 year after glioma surgery.Binary logistic regression analysis was used to analyze the risk factors of postoperative recurrence of glioma.Results Postoperative pathological results showed that there were 45 cases(35.71%)of low-grade group and 81 cases(64.29%)of high-grade group among these 126 patients with glioma.The difference between the proportion of patients over 60 years old,serum MBP,CEA and the PNI in the two groups were statistically significant(P<0.05).Serum levels of MBP and CEA in patients with glioma were positively correlated with WHO grading(P<0.05),and PNI was negatively correlated with WHO grading(P<0.05).After glioma surgery,56 cases(44.44%)recurred within 1 year.Compared with non-recurrence group,the proportions of patients with age>60 years old and tumor diameter>5 cm,serum MBP and CEA in recurrence group increased(P<0.05)while their PNI was reduced(P<0.05).The AUCs of serum MBP,CEA and PNI in predicting the recurrence at 1 year after glioma surgery were 0.819,0.868 and 0.749 respectively,and the AUC of combined prediction was 0.892(P<0.05).Age,tumor diameter,serum MBP,CEA and PNI were risk factors for recurrence at 1 year after glioma surgery(P<0.05).Conclusions Serum MBP,CEA and PNI are closely associated with the malignancy degree and postoperative recurrence of gliomas.The combined use of these three indicators for predicting 1-year postoperative recurrence demonstrates superior efficacy compared to any single indicator alone.This approach can be applied in clinical settings to assist the assessing of the risk of glioma recurrence,providing valuable references for optimizing treatment strategies.
作者
孙宇婷
郭华
苏建龙
甄文剑
郝进敏
SUN Yuting;GUO Hua;SU Jianlong;ZHEN Wenjian;HAO Jinmin(Department of Neurosurgery,Xingtai Central Hospital/Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期93-98,共6页
Chinese Journal of Neurosurgical Disease Research
基金
邢台市市级科技计划自筹经费项目(2024ZC215)。
关键词
脑胶质瘤
髓鞘碱性蛋白
癌胚抗原
预后营养指数
WHO中枢神经系统肿瘤分类
术后复发
危险因素
Glioma
Myelin basic protein
Carcinoembryonic antigen
Prognostic nutritional index
WHO central nervous system tumor grading
Postoperative recurrence
Risk factors
