脑脊液与血清细胞因子比值在高级别胶质瘤与脑转移瘤中的鉴别诊断价值研究

A Study on the Differential Diagnostic Value of Cerebrospinal Fluid to SerumCytokine Ratio in High- grade Gliomas and Brain Metastases

目的研究高级别胶质瘤(high-grade glioma,HGG)和脑转移瘤(brain metastases,BM)患者脑脊液(cerebrospinal fluid,CSF)和血清(Serum)中细胞因子的比值水平,探究其鉴别诊断意义。方法收集2023年1月至2023年8月于首都医科大学附属北京天坛医院神经外科收治的脑瘤患者。所有患者进行12种生物标志物检测,探究CSF(下文简称C)和Serum(下文简称S)中细胞因子比值水平在脑瘤鉴别诊断方面的临床意义。结果共收集患者136例,根据脑瘤不同类型分为HGG组(n=106)和BM组(n=30),单因素分析后显示两组患者的发病年龄差异有统计学意义(P<0.01),两组患者细胞因子白细胞介素-2受体(interleukin-2 receptor,IL-2R)和白细胞介素-6(interleukin-6,IL-6)的C与S比值差异有统计学意义(P<0.01),通过ROC曲线分析,细胞因子中IL-6和IL-2R的C与S比值具有诊断意义,其cut-off值分别为1.92和0.105,对其进行联合诊断显示,其AUC为0.809。结论HGG患者发病年龄较BM患者轻,联合C/S-IL-6和C/S-IL-2R可在HGG与BM的鉴别诊断中提供较高临床价值。

Objective To study the ratio levels of cytokines in cerebrospinal fluid(CSF)and serum(Serum)of patients with high-grade glioma(HGG)and brain metastases(BM),and to explore their differential diagnostic significance.Methods We enrolled brain tumor patients admitted to the Neurosurgery Department of Beijing Tiantan Hospital Affiliated to Capital Medical University from January,2023 to August,2023.All patients underwent 12 biomarker tests to explore the clinical significance of cytokine ratio levels in CSF(hereinafter referred to as C)and Serum(hereinafter referred to as S)in the differential diagnosis of brain tumors.Results A total of 136 patients were collected and divided into HGG group(n=106)and BM group(n=30)based on different types of brain tumors.Univariate analysis showed a significant difference in the onset age of the two groups of patients(P<0.01).The C to S ratio of cytokines,interleukin-2 receptor(IL-2R),and interleukin-6(IL-6)in the two groups of patients showed a significant difference(P<0.01).ROC curve analysis showed that the C to S ratio of IL-6 and IL-2R in cytokines had a diagnostic significance,with cut-off values of 1.92 and 0.105,respectively.Combined diagnosis showed an AUC of 0.809.Conclusion HGG patients have a younger onset age than BM patients,and the combination of C/S-IL-6 and C/S-IL-2R can provide a high clinical value in the differential diagnosis of HGG and BM.