首页|术前血清学指标对脑胶质瘤分级和异柠檬酸脱氢酶状态具有预测意义

术前血清学指标对脑胶质瘤分级和异柠檬酸脱氢酶状态具有预测意义

扫码查看
目的 探讨术前血清学指标对弥漫性胶质瘤异柠檬酸脱氢酶(IDH)突变和世界卫生组织(WHO)级别的预测意义.方法 本研究共纳入1058例在郑州大学第一附属医院接受手术治疗的WHO Ⅱ~Ⅳ级胶质瘤患者,获取患者临床资料和术前血清学指标并检测IDH突变.t检验和Logistic回归用于挖掘独立相关因素,通过ROC曲线评估血清学指标对WHO级别和IDH突变的预测意义.结果 在独立样本t检验中,IDH野生组PDW(P<0.05)、MPV(P<0.001)高于IDH突变组,IDH 野生组 AGR(P<0.001)低于 IDH 突变组.WHO Ⅳ 级组的PDW(P<0.05)、MPV(P<0.001)、NLR(P<0.05)、PLR(P<0.05)和 SⅡ(P<0.05)高于 WHO Ⅱ~Ⅲ级组,WHO Ⅳ 级组的AGR(P<0.001)低于 WHO Ⅱ~Ⅲ级组.Logistic 回归分析显示年龄(P<0.001)、MPV(P<0.001)和AGR(P<0.001)是IDH突变的独立预测因子.此外,较高的年龄(P<0.001)、MPV(P<0.001)和PLR(P<0.05)以及较低的AGR(P<0.001)预示着较高的WHO级别.通过绘制ROC曲线,结果显示MPV、AGR和年龄联合应用对IDH突变有最好的预测效果,曲线下面积(AUC)为0.789.对于WHO级别,MPV、PLR、AGR和年龄的联合预测更为有效和准确,AUC为0.774.结论 术前血清学指标联合患者年龄可有效预测弥漫性胶质瘤患者IDH突变和WHO级别.
Preoperative hematological indicators have predictive significance for glioma World Health Organi-zation grade and isocitrate dehydrogenase status
Objective To explore the predictive significance of serological parameters for isocitrate dehydrogenase(IDH)mutation and World Health Organization(WHO)grades in diffuse glioma.Methods A total of 1 058 cases of WHO Grade Ⅱ-Ⅳ glioma patients who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University were enrolled in this study.Detailed clinical information and hematological parameters were collected and IDH mutation status was detected.The independent related factors were determined by t-test and Logistic regression analysis,and the receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic and predictive significance of hematological markers and their paired combinations for WHO grades and IDH status.Results For independent sample t-test,the PDW(P<0.05)and MPV(P<0.001)of the IDH wild group were higher than those of the IDH mutant group,while the AGR(P<0.001)of the IDH wild group was lower than that of the IDH mu-tant group.The PDW(P<0.05),MPV(P<0.001),NLR(P<0.05),PLR(P<0.05),and SⅡ(P<0.05)of the WHO Ⅳ group were higher than those of the WHO Ⅱ-Ⅲ group,while the AGR(P<0.001)of the WHO Ⅳ group was lower than that of the WHO Ⅱ-Ⅲgroup.The results of logistic regression analy-sis showed that age(P<0.001),MPV(P<0.001)and AGR(P<0.001)were independent predictors of IDH status.In addition,older age(P<0.001),higher MPV(P<0.001)and higher PLR(P<0.05)and lower AGR(P<0.001)indicated higher WHO grades.By drawing ROC curve,it was found that the combined application of MPV,AGR and age had the best prediction effect on IDH mutation with the area under curve(AUC)of 0.789.For WHO grades,the combined prediction of MPV,PLR,AGR and age was more effective and accurate with AUC of 0.774.Conclusion The combination of preoperative hema-tological indicators and patient age can effectively predict IDH mutation and WHO grades in patients with diffuse glioma.

GliomasSerological parametersIsocitrate dehydrogenaseWorld health organ-izationPrediction model

毛冲冲、张庆浩、于洋、邱锴、冯亚文、刘献志

展开 >

郑州大学第一附属医院神经外科,郑州 450000

胶质瘤 血清学指标 异柠檬酸脱氢酶 世界卫生组织 预测模型

2024

中华实验外科杂志
中华医学会

中华实验外科杂志

CSTPCD
影响因子:0.759
ISSN:1001-9030
年,卷(期):2024.41(6)
  • 3