血清神经特异性烯醇化酶与脑胶质瘤患者术后脑损伤的相关性

Relationship between serum neuron-specific enolase and postoperative brain injury in glioma patients

目的探讨脑胶质瘤患者手术前、后血清神经特异性烯醇化酶(neuron-specific enolase, NSE)水平与脑组织损伤的关系。方法 48例经手术治疗的脑胶质瘤患者,于术前1 d及术后1、3、7 d分别检测血清NSE水平,并进行手术前、后比较;收集手术前、后影像学资料,采用Pearson或Spearman相关分析血清NSE水平与肿瘤体积、脑组织水肿体积及术后6个月KPS功能评分的相关性。结果术后1、3、7 d时患者血清NSE水平[(15.07±2.34)、(18.20±4.31)、(15.20±3.94)μg/L]均高于术前[(12.98±2.61)μg/L](P<0.05),术后3 d时高于术后1 d时(P<0.05),术后7 d与术后1 d比较差异无统计学意义(P>0.05);不同部位、不同级别脑胶质瘤患者手术前、后血清NSE水平比较差异均无统计学意义(P>0.05);术前血清NSE水平与瘤周水肿体积呈正相关(r=0.757,P<0.001),与肿瘤体积无相关性(r=0.190,P=0.195);术后3 d血清NSE水平与术后3 d脑水肿体积呈正相关(r=0.553,P=0.002),术后7 d血清NSE水平与术后6个月KPS评分(80分)呈负相关性(r=-0.821,P<0.001)。结论血清NSE水平可辅助评估脑胶质瘤手术患者的脑损伤程度变化。

Objective To investigate the correlation of serum neuron-specific enolase(NSE) level before and after surgery with brain injury in glioma patients. Methods The serum NSE level was detected on the 1 st preoperative day, as well as on the 1 st, 3 rd and 7 th postoperative days in 48 patients with glioma, and was compared before and after operation. The imaging data were collected. The correlations of serum NSE level with the volume of glioma, brain edema volume and KPS functional score in 6 months after operation were analyzed by Pearson or Spearman correlation analysis. Results The serum level of NSE was higher on the 1 st, 3 rd and 7 th postoperative days((15.07±2.34),(18.20±4.31),(15.20±3.94) μg/L) than that before operation((12.98±2.61) μg/L)(P<0.05), higher on the 3 rd postoperative day than that on the 1 st postoperative day(P<0.05), and showed no significant difference on the 7 th postoperative day compared with that on the 1 st postoperative day(P>0.05). There were no significant differences in serum NSE levels between different sites and different grades of glioma before and after operation(P>0.05). The preperative serum NSE level was positively correlated with peritumor edema volume(r=0.757, P<0.001), and was not correlated with the volume of glioma(r=0.190, P=0.195). The serum NSE level on the 3 rd postoperative day was positively correlated with cerebral edema volume(r=0.553, P=0.002), and the serum NSE level on the 7 th postoperative day was negatively correlated with KPS score(80) in 6 months after operation(r=-0.821, P<0.001). Conclusion The serum NSE level can be used to assess the degree of brain injury in patients with glioma.