颅脑肿瘤术后患者血清NSE MBP RDW与预后的相关性研究

Correlationbetween serum NSE,MBP,RDW and prognosis in patients with craniocerebral tumors

目的探讨颅脑肿瘤患者血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、红细胞分布宽度(RDW)与预后的相关性。方法选取2017-01—2019-01收治于南阳市第二人民医院的200例颅脑肿瘤患者为研究对象,均进行1 a随访,依据颅脑肿瘤患者随访后格拉斯哥预后评分(GOS)分为预后良好组(GOS≥3分)42例与预后不良组(GOS<3分)158例,对2组临床资料和血清NSE、MBP及RDW水平进行回顾性分析。结果单因素分析显示2组术前行为状态量表(KPS)、术后放化疗、颅外转移、血清NSE、血清MBP、RDW水平方面存在显著差异(P<0.05);多因素分析显示术后未放化疗、颅外转移、血清NSE水平≥10μg/L、血清MBP水平≥8μg/L和RDW水平≥15%是颅脑肿瘤患者预后不良的独立预测因素。ROC分析显示血清NSE、MBP及RDW水平联合预测颅脑肿瘤患者预后不良的AUC值明显高于三者单独预测时的AUC值(P<0.05),且NSE、MBP、RDW单独预测颅脑肿瘤预后不良时的截断值分别为12.206μg/L、18.439μg/L和15.588%。结论颅脑肿瘤患者的血清NSE、MBP及RDW水平可作为其预后的可靠标志物,三者联合检测对预测颅脑肿瘤患者预后有较高的价值。

Objective To explore the correlation between serum neuron-specific enolase(NSE),myelin basic protein(MBP),red cell distribution width(RDW)and prognosis in patients with craniocerebral tumors.Methods A total of 200 patients with craniocerebral tumors who were admitted to the hospital from January 2017 to January 2019 were enrolled as the research subjects.All were followed up for 1 year.According to GOS scores,they were divided into good prognosis groups(GOS not lower than 3 points)and poor prognosis group(GOS lower than 3 points).After follow-up,of the 200 patients with craniocerebral tumors,there were 158 cases with GOS score lower than 3 points(poor prognosis group)and 42 cases with GOS score not lower than 3 points(good prognosis group).The clinical data and levels of serum NSE,MBP and RDW in both groups were retrospectively analyzed.Results Univariate analysis results showed that the differences in KPS scores at admission,postoperative radiochemotherapy,extracranial metastasis,levels of serum NSE,MBP and RDW were statistically significant between the two groups(P<0.05).Multivariate analysis results showed that no postoperative radiochemotherapy,extracranial metastasis,serum NSE level not lower than 10μg/L,serum MBP level not lower than 8μg/L and RDW level not lower than 15%were independent predictors of poor prognosis in patients with craniocerebral tumors.ROC analysis results showed that AUC of serum NSE combined with MBP and RDW for predicting poor prognosis was significantly greater than that of single index(P<0.05).And the cutoff values of NSE,MBP and RDW for predicting poor prognosis of craniocerebral tumors were 12.206μg/L,18.439μg/L and 15.588%,respectively.Conclusion The levels of serum NSE,MBP and RDW can be applied as reliable markers of prognosis in patients with craniocerebral tumors.The combined detection of the three is of good application value in clinically predicting prognosis.