术前血清学指标对脑胶质瘤分级和异柠檬酸脱氢酶状态具有预测意义  

Preoperative hematological indicators have predictive significance for glioma World Health Organization grade and isocitrate dehydrogenase status

作　　者：毛冲冲[1] 张庆浩 于洋[1] 邱锴[1] 冯亚文[1] 刘献志[1] Mao Chongchong;Zhang Qinghao;Yu Yang;Qiu Kai;Feng Yawen;Liu Xianzhi(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院神经外科,郑州450000

出　　处：《中华实验外科杂志》2024年第6期1291-1294,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨术前血清学指标对弥漫性胶质瘤异柠檬酸脱氢酶(IDH)突变和世界卫生组织(WHO)级别的预测意义。方法本研究共纳入1058例在郑州大学第一附属医院接受手术治疗的WHOⅡ~Ⅳ级胶质瘤患者,获取患者临床资料和术前血清学指标并检测IDH突变。t检验和Logistic回归用于挖掘独立相关因素,通过ROC曲线评估血清学指标对WHO级别和IDH突变的预测意义。结果在独立样本t检验中,IDH野生组PDW(P<0.05)、MPV(P<0.001)高于IDH突变组,IDH野生组AGR(P<0.001)低于IDH突变组。WHOⅣ级组的PDW(P<0.05)、MPV(P<0.001)、NLR(P<0.05)、PLR(P<0.05)和SII(P<0.05)高于WHOⅡ~Ⅲ级组,WHO IV级组的AGR(P<0.001)低于WHOⅡ~Ⅲ级组。Logistic回归分析显示年龄(P<0.001)、MPV(P<0.001)和AGR(P<0.001)是IDH突变的独立预测因子。此外,较高的年龄(P<0.001)、MPV(P<0.001)和PLR(P<0.05)以及较低的AGR(P<0.001)预示着较高的WHO级别。通过绘制ROC曲线,结果显示MPV、AGR和年龄联合应用对IDH突变有最好的预测效果,曲线下面积(AUC)为0.789。对于WHO级别,MPV、PLR、AGR和年龄的联合预测更为有效和准确,AUC为0.774。结论术前血清学指标联合患者年龄可有效预测弥漫性胶质瘤患者IDH突变和WHO级别。Objective To explore the predictive significance of serological parameters for isocitrate dehydrogenase(IDH)mutation and World Health Organization(WHO)grades in diffuse glioma.Methods A total of 1058 cases of WHO GradeⅡ-Ⅳglioma patients who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University were enrolled in this study.Detailed clinical information and hematological parameters were collected and IDH mutation status was detected.The independent related factors were determined by t-test and Logistic regression analysis,and the receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic and predictive significance of hematological markers and their paired combinations for WHO grades and IDH status.Results For independent sample t-test,the PDW(P<0.05)and MPV(P<0.001)of the IDH wild group were higher than those of the IDH mutant group,while the AGR(P<0.001)of the IDH wild group was lower than that of the IDH mutant group.The PDW(P<0.05),MPV(P<0.001),NLR(P<0.05),PLR(P<0.05),and SII(P<0.05)of the WHOⅣgroup were higher than those of the WHOⅡ-Ⅲgroup,while the AGR(P<0.001)of the WHOⅣgroup was lower than that of the WHOⅡ-Ⅲgroup.The results of logistic regression analysis showed that age(P<0.001),MPV(P<0.001)and AGR(P<0.001)were independent predictors of IDH status.In addition,older age(P<0.001),higher MPV(P<0.001)and higher PLR(P<0.05)and lower AGR(P<0.001)indicated higher WHO grades.By drawing ROC curve,it was found that the combined application of MPV,AGR and age had the best prediction effect on IDH mutation with the area under curve(AUC)of 0.789.For WHO grades,the combined prediction of MPV,PLR,AGR and age was more effective and accurate with AUC of 0.774.Conclusion The combination of preoperative hematological indicators and patient age can effectively predict IDH mutation and WHO grades in patients with diffuse glioma.

关 键 词：胶质瘤 血清学指标 异柠檬酸脱氢酶 世界卫生组织 预测模型 

分 类 号：R739.4[医药卫生—肿瘤]