血清玻粘连蛋白在人脑胶质瘤诊断及预后判定中的应用价值

The value of serum laminin in the diagnosis and prognosis of human gliomas

目的:探讨血清玻粘连蛋白(VTN)在人脑胶质瘤诊断及预后判定中的应用价值。方法:选择2010年1月至2015年6月在我院就诊的163例脑胶质瘤患者作为研究组,同时选择同期健康体检受试者108例作为对照1组,非胶质瘤脑肿瘤患者47例作为对照2组,非肿瘤神经内科疾病患者92例作为对照3组。收集受试者空腹静脉血,检测血清VTN,观察VTN与脑胶质瘤诊断与预后的关系。结果:四组患者VTN水平相比较差异有统计学意义(P<0.05),研究组VTN水平显著高于对照1组、对照2组和对照3组(P<0.05)。ROC显示VTN诊断脑胶质瘤的灵敏度、特异性和AUC分别为0.779、0.907和0.881。患者年龄、病理分级、KPS评分、肿瘤直径、体质指数(BMI)与VTN水平相关(P<0.05),性别、肿瘤部位、病程与VTN水平无相关性(P>0.05)。多因素Cox分析,结果显示,肿瘤分级(RR=9.872,P<0.001)、VTN水平(RR=4.786,P<0.001)是影响1年无进展生存率的独立因素(P<0.05)。K-M曲线显示,VTN低表达组中位PFS显著高于VTN高表达组(19.2个月vs9.9个月,P<0.001)。结论:VTN对诊断脑胶质瘤具有中等临床价值,是一种有用的预后生物标志物。

Objective:To investigate the value of serum vitronectin (VTN) in the diagnosis and prognosis of human glioma.Methods:From January 2010 to June 2015,163 patients with glioma in our hospital were selected as the study group,108 healthy subjects in the same period were selected as the control group 1,47 patients with non-glioma brain tumors as the control group 2,and 92 patients with non-tumor neurological diseases as the control group 3.The fasting venous blood was collected and serum laminin (VTN) was detected.The relationship between VTN and diagnosis and prognosis of glioma was observed.Results:There was a significant difference in VTN level in the four groups ( P <0.05).The level of VTN in the study group was significantly higher than that in the control group 1,the control group 2 and the control 3 group ( P <0.05).The ROC showed that the sensitivity,specificity and AUC of VTN in diagnosing glioma were 0.779,0.907 and 0.881 respectively.The age,pathological grade,KPS score,tumor diameter and BMI were correlated with VTN level ( P <0.05),but gender,tumor location and course were not correlated with VTN level ( P >0.05).Multivariate Cox analysis showed that tumor grade (RR=9.872,P <0.001) and VTN level (RR=4.786,P <0.001) were independent factors affecting 1-year progression-free survival ( P <0.05).The K-M curve showed that the median PFS of VTN low expression group was significantly higher than that of VTN high expression group (19.2 months vs 9.9 months,P <0.001).Conclusion:The VTN has a moderate clinical value in the diagnosis of glioma and is a useful prognostic biomarker.