脑脊液D-二聚体对脑胶质瘤的诊断意义  

Clinical significance of cerebrospinal fluid dimer in glioma

作　　者：孟磊[1] 郭云双 申法政[1] 王俊伟 李海明 赵新利[1] Meng Lei;Guo Yunshuang;Shen Fazheng;Wang Junwei;Li Haiming;Zhao Xinli(Department of Neurosurgery,First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China;Cardiac Intensive Care Unit,First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan453100,China;Henan Key Laboratory of Neurorestoratology,First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院神经外科,河南新乡453100 [2]新乡医学院第一附属医院心脏重症监护室,河南新乡453100 [3]新乡医学院第一附属医院,河南省神经修复重点实验室,河南新乡453100

出　　处：《实用医技杂志》2023年第7期462-466,共5页Journal of Practical Medical Techniques

基　　金：新乡医学院第一附属医院青年培育基金(QN-2020-B07);河南省医学科技攻关计划联合共建项目(LHGJ20210515)。

摘　　要：目的测定脑胶质瘤患者术前、术后以及后续放化疗过程中的脑脊液D-二聚体水平,探讨脑脊液D-二聚体水平对脑胶质瘤的诊断分级、治疗效果及评估预后的临床意义。方法纳入2019年3月1日至2022年3月1日于新乡医学院第一附属医院接受手术治疗并后续放化疗的患者68例,分别于术前、术后1周,术后1个月、术后3个月、术后6个月及术后12个月留取脑脊液标本测定D-二聚体水平;分别比较脑胶质瘤与脑膜瘤(对照组)、不同级别脑胶质瘤、脑胶质瘤术前与术后、进展前后脑脊液D-二聚体水平以及治疗过程中的脑脊液D-二聚体水平变化,采用受试者工作特征曲线分析各个级别脑胶质瘤脑脊液D-二聚体水平的截断值,总结其水平变化的临床意义。结果低级别胶质瘤组与脑膜瘤对照组血浆D-二聚体水平相比,差异无统计学意义(P=0.971);Ⅲ级及Ⅳ级胶质瘤组与脑膜瘤对照组血浆D-二聚体水平相比,含量均升高,差异均具有统计学意义(P<0.01);伴随胶质瘤级别的增高,血浆D-二聚体水平升高,各级别之间差异均具有统计学意义(P<0.01);术后脑脊液D-二聚体水平低于术前组(P<0.01),全切患者脑脊液D-二聚体水平下降率高于未全切患者(P<0.01);进展后患者脑脊液D-二聚体水平高于进展前(P<0.01)。低级别、Ⅲ级及Ⅳ级脑胶质瘤患者脑脊液D-二聚体含量受试者工作特征曲线中脑脊液D-二聚体截断值分别为96.84 ng/ml、588.82 ng/ml和8855.24 ng/ml。结论脑脊液D-二聚体可作为脑胶质瘤的诊断分级、治疗效果及评估预后的标志物。Objective To determine cerebrospinal fluid(CSF)D-dimer levels in patients with cerebral gliomas during preoperative and postoperative periods as well as during subsequent radiotherapy,and to investigate the clinical significance of CSF D-dimer level in the diagnostic classification of cerebral gliomas,therapeutic effect and prognosis of glioma.Methods A total of 68 patients who underwent surgery and subsequent radiotherapy and chemotherapy at the First Affiliated Hospital of Xinxiang Medical University from March 1,2019 to March 1,2022 were included,D-dimer level was collected and measured before preoperative,1 week after surgery,1 month after surgery,3 months after surgery,6 months after surgery and 12 months after surgery respectively.To compare the level of CSF D-dimer between glioma and meningioma(control group),preoperative and postoperative after brain glioma,before and after progression,and Changes in CSF D-dimer level during treatment,CSF D-dimer levels were analyzed by receiver operating characteristic curve(ROC),thereby analyzing and summarizing the clinical significance of its level.Results There was no statistically significant difference in plasplasma D-dimer levels in the low-grade glioma group compared with the meningioma control group(P=0.971);the plasma D-dimer levels in the gradeⅢand gradeⅣglioma groups compared with the meningioma control group,the differences were all statistically significant in all cases(P<0.01).With the increased glioma grade,increated plasma levels of D-dimer,the differences between all levels were statistically significant(P<0.01);The CSF D-dimer level was significantly lower than in the preoperative group(P<0.01);the decrease rate of CSF D-dimer level in total excision patients was significantly higher than partial excision patients(P<0.01);CSF D-dimer levels were higher in patients after progression than before progression(P<0.001).The CSF D-dimer Cut-off value in the ROC curve of CSF D-dimer level in low-grade,ⅢandⅣ-grade glioma patients was 96.84 ng/ml,588.82

关 键 词：神经胶质瘤 脑脊液漏 酶联免疫吸附测定 

分 类 号：R739.41[医药卫生—肿瘤]