Objective To investigate the expression of chitinase protein 40(YKL-40)in peripheral blood of patients with meningioma and its effect on postoperative cerebral edema.Methods Total of 120 patients with meningioma diagnosed and treated in Hainan Western Central Hospital from January 2020 to January 2023 were selected as the observation group,and the observation Ⅰ group refered to the patients who had no edema before and after the operation.The observation Ⅱ group refered to the patients who had no edema before the operation but developed edema after the operation.The observation Ⅲ group refered to the patients who had edema before the operation but it did not worsen after the operation.The observation Ⅳ group refered to the patients who had edema before the operation and it worsened after the operation.And 120 healthy subjects served as the control group.The serum YK 1-40 levels between the two groups were compared.Results The serum YKL-40 level of the observation group was higher than that of the control group before surgery,3 d after surgery,7 d after surgery and 14 d after surgery(P＜0.05).The serum YKL-40 level in the observation group was higher than that before surgery at 3 d after surgery,and decreased at 7 d and 14 d after surgery(P＜0.05).At different time points,the serum YKL-40 levels in observation groups Ⅰ to Ⅳ showed an increasing trend(P＜0.05).Among 120 patients with meningioma,32 cases showed increased cerebral edema after operation,with an incidence of 26.67％(32/120).Preoperative peritumoral edema was a protective factor for postoperative cerebral edema in patients with meningioma(P＜0.05).The tumor site was adjacent to the falx of the sinuses and the increased level of YKL-40 before surgery was a risk factor for the aggravation of postoperative cerebral edema in patients with meningioma,and Preoperative peritumoral edema was a protective factor for postoperative aggravated cerebral edema in patients with meningioma(P＜0.05).The AUC values of YKL-40 and combined prediction model for postoperative aggravated cerebral edema in patients with meningioma were 0.765 and 0.854,respectively,and the AUC values evaluated by combined prediction model were higher than those evaluated by YKL-40 alone(Z=2.318,P=0.021).There was a nonlinear dose-response relationship(x2=12.000,P=0.003)between the continuous change of YKL-40 and the incidence of postoperative aggravated cerebral edema in meningioma patients.Conclusion The level of YKL-40 in peripheral blood increases in patients with meningioma,and the abnormal increase of YKL-40 was associated with the aggravation of postoperative cerebral edema,suggesting that patients with YKL-40＞20 ng/L should be vigilant about the risk of aggravation of postoperative cerebral edema.
chitinase protein 40meningiomapostoperative cerebral edema aggravatedmicrosurgical excision
维普
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