摘要
目的探讨胶质瘤患者术前外周血液炎症指标与胶质瘤病理分级、IDH1基因表型的相关性。方法回顾性分析2015-12—2020-09在徐州医科大学附属医院首次接受手术治疗的465例胶质瘤患者的临床病理资料,通过Kruskal-Wallis进行非参数检验、Spearman相关性分析、受试者工作特性曲线(ROC曲线)分析术前外周血中性粒细胞-淋巴细胞比值(NLR)、衍生中性粒细胞-淋巴细胞比值(dNLR)、血小板-淋巴细胞比值(PLR)、单核细胞-淋巴细胞比值(MLR)、预后营养指数(PNI)与胶质瘤病理分级、IDH1基因表型的关系。结果共纳入465例胶质瘤患者(其中WHOⅠ级30例,WHOⅡ级134例,WHOⅢ级88例,WHOⅣ级213例)与450例健康对照者。非参数检验显示不同病理分级的胶质瘤患者术前NLR、dNLR、PLR和MLR的表达存在显著差异(P<0.05)。Spearman相关性分析显示胶质瘤患者术前NLR、PLR、MLR与WHO分级均存在正相关性(r分别为0.379、0.238、0.226,P<0.01),而胶质瘤患者术前PNI与病理分级有明显的负相关性(r=0.411,P<0.01)。IDH1突变与PNI呈正相关(r=0.108,P<0.05),IDH1突变与病理分级、NLR均呈负相关(r分别为0.353、0.105,P<0.05)。与健康对照组相比,胶质母细胞瘤患者NLR的受试者工作特性曲线下面积(AUC)为0.816(95%CI 0.764~0.848),dNLR为0.588(95%CI 0.537~0.640),PLR为0.673(95%CI 0.624~0.773),MLR为0.682(95%CI 0.633~0.731)。术前外周血液炎症指标对胶质母细胞瘤的预测价值显著高于Ⅰ~Ⅲ级胶质瘤患者。结论胶质瘤患者术前NLR、dNLR、PLR、MLR、PNI与胶质瘤病理分级、IDH1基因表型相关,对术前预测胶质瘤的病理分级有一定的参考价值。
Objective Objective To investigate the correlation between preoperative blood inflammatory indexes,pathological grade and IDH1 gene phenotype in patients with glioma.Methods A retrospective analysis of the clinicopathological data of 465 patients with glioma and 450 healthy people who underwent surgery in the Affiliated Hospital of Xuzhou Medical University from December 2015 to September 2020 was performed by Kruskal-Wallis for non-parametric tests.Spearman correlation analysis,receiver operating characteristic curve(ROC curve)analysis of the relationship between preoperative NLR(neutrophil to lymphocyte ratio),dNLR(derived neutrophil to lymphocyte ratio),PLR(platelet to lymphocyte ratio),MLR(monocyte to lymphocyte ratio),PNI(prognostic nutritional index),glioma pathological grade,IDH1 gene phenotype.Results The non-parametric test showed that there were significant differences in the expression of NLR,dNLR,PLR and MLR in glioma patients with different pathological grades(all P<0.05).The results of Spearman rank correlation analysis showed that the NLR,PLR,MLR and WHO classification of glioma patients were significantly positively correlated(r=0.379,0.238,0.226,P<0.01),while preoperative PNI and glioma patients The pathological grading has obvious negative correlation(r=0.411,P<0.01).IDH1 mutation was positively correlated with PNI(r=0.108,P<0.05),IDH1 mutation was negatively correlated with pathological grade and NLR(r=0.353,0.105,P<0.05).As compared with the healthy controls,the GBM patients had an area under the curve(AUC)obtained from the ROC curve was 0.816(95%CI 0.764-0.848)for NLR,0.588(95%CI 0.537-0.640)for dNLR,0.673(95%CI 0.624-0.773)for PLR,0.682(95%CI 0.633-0.731)for MLR.The predictive value of plasmoblastoma is significantly higher than that of patients with gradeⅠ-Ⅲglioma.Conclusion Preoperative NLR,dNLR,PLR,MLR,PNI are related to the pathological grade of glioma and IDH1 gene phenotype in patients with glioma.It has certain reference value for predicting the pathological grade of glioma before
作者
赵赛赛
赵保祥
王铮
陆冬
聂耳
谢满意
王强
李中林
ZHAO Saisai;ZHAO Baoxiang;WANG Zheng;LU Dong;NIE Er;XIE Manyi;WANG Qiang;LI Zhonglin(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国实用神经疾病杂志》
2021年第6期475-481,共7页
Chinese Journal of Practical Nervous Diseases
基金
江苏省青年科学基金项目(编号:81802490)。
