神经胶质瘤患者术前血清NLRP3、ILs表达水平对预后的影响研究

Effect of serum NLR family pyrin domain-containing protein 3(NLRP3)and interleukins(ILs)expression levels on prognosis of patients with glioma before operation

目的研究术前NLR家族Pyrin域蛋白3(NLR family pyrin domain-containing protein 3,NLRP3)、白细胞介素(Interleukin,ILs)表达谱特征对神经胶质瘤患者手术预后的影响。方法以2019年1月-2022年12月新疆医科大学第二附属医院神经外科收治的86例神经胶质瘤患者为研究对象,根据患者术后1年内随访情况将患者划分为手术预后良好组(n=52)和手术预后不良组(n=34)。对比两组患者一般临床资料及术前NLRP3、ILs(IL-1β、IL-4、IL-12、IL-17、IL-33)表达谱的表达水平差异。采用Spearman相关性分析,经单因素及多因素Logistic回归分析筛选神经胶质瘤患者手术预后不良的危险因素,通过受试者工作特征(Receiver operating characteristic,ROC)曲线评价各危险因素对患者手术预后的影响。结果与手术预后良好组比较,手术预后不良组患者肿瘤大小、肿瘤周围水肿患者比例、合并癫痫发作史患者比例、血清NLRP3、IL-1β、IL-4、IL-33水平均升高,术前卡氏功能状态评分、血清IL-12水平均降低,差异有统计学意义(P<0.05);Spearman相关性分析结果表明,肿瘤大小、肿瘤周围水肿、有癫痫发作史、血清中NLRP3、IL-1β、IL-4、IL-33水平均与手术预后不良呈正相关性,卡氏功能状态评分、IL-12与手术预后不良呈负相关性(P<0.05);单因素及多因素Logistic回归分析表明血清中NLRP3、IL-1β、IL-4水平均是神经胶质瘤患者手术预后不良的重要危险因素,IL-12是神经胶质瘤患者手术预后不良的重要保护因素(P<0.05);ROC曲线分析表明NLRP3、IL-1β、IL-4、IL-12独立及联合对于神经胶质瘤患者手术预后不良均具有较高预测效能(P<0.05)。结论神经胶质瘤患者NLRP3、ILs水平较高均是手术预后不良的重要危险因素,通过早期干预减轻神经胶质瘤患者炎症水平可能有利于改善手术治疗效果。

Objective To investigate the impact of preoperative expression profile characteristics of NLR family pyrin domain-containing protein 3(NLRP3)and interleukins(ILs)on the surgical prognosis of the patients with gliomabefore operation.Methods 86 patients diagnosed with glioma who received surgical treatment in the hospital between January 2019 to December 2022 were selected for this study.Based on their postoperative progress within a year,thepatients were categorized into a favorable surgical outcome group consisting of 52 patients and an unfavorable surgical outcome group consisting of 34 patients.Dis-parities in general clinical characteristics and preoperative expression levels of NLRP3 and interleukins(IL-1β,IL-4,IL-12,IL-17,IL-33)between these 2 groups were analyzed.Spearman correlation analysis,as well as univariate and multivariate Logistic regression analysis,were conducted to identify the potential risk factors associated with poor surgical outcomes in glioma patients.The significance of each risk factor on surgical prognosis was assessed using the receiver operating characteristic(ROC)curve.Results Com-pared with the group with good surgical prognosis,thepatients in the group with poor surgical prognosis showed increased tumor size,a higher proportion of the patients with peritumoral edema,a higher propor-tion of thepatients with a history of epileptic seizures,and elevated serum levels of NLRP3,IL-1β,IL-4 and IL-33.Additionally,preoperative Karnofsky Performance Status scores and IL-12 levels were de-creased,and these differences were statistically significant(P<0.05).Spearman correlation analysis demonstrated a positive association between tumor size,peritumoral edema,history of epileptic seizures,levels of serum NLRP3,IL-1β,IL-4 and IL-33 with poor surgical prognosis,while a negative correlation was observed between Karnofsky performance status score and level of serum IL-12 with poor surgical prognosis(P<0.05).Univariate and multivariate Logistic regression analyses highlighted NLRP3,IL-1βand IL-4 as noteworthy risk factors for unfavorable surgical outcomes in glioma patients,with IL-12 iden-tified as a significant protective factor against poor surgical prognosis in this patient population(P<0.05).ROC curve analysis underscored the robust predictive capability of NLRP3,IL-1β,IL-4 and IL-12,both individually and in combination,for identifying patients at risk of poor surgical outcomes in glioma cases(P<0.05).Conclusion High levels of NLRP3 and ILs inglioma patientsare important risk factors for poor prognosis after surgery.Reducing inflammation levels in glioma patients through early interven-tion may be conducive to improving surgical treatment results.