摘要
目的探讨成人型弥漫性脑胶质瘤瘤周水肿(PTBE)区膜联蛋白A2(ANXA2)的表达与PTBE的关系.方法回顾性分析2020年6月至2021年8月北京大学第三医院神经外科行肿瘤切除术治疗的42例成人型弥漫性脑胶质瘤患者的临床资料.采用术前头颅MRI测量水肿指数(EI),依据EI将患者分为轻度、中度及重度PTBE.采用免疫组织化学染色技术(IHC)检测PTBE区ANXA2的表达情况,计算IHC评分,将患者分为ANXA2高表达组(IHC评分≥6分)和低表达组(IHC评分<6分);比较两组患者的PTBE程度.进一步通过单因素和多因素logistic回归分析和Spearman相关分析评估ANXA2与PTBE程度的关系.结果ANXA2高表达组(26例)与低表达组(16例)PTBE程度的差异具有统计学意义(P=0.001),ANXA2高表达组重度水肿者占比更高.单因素logistic回归分析显示,ANXA2高表达(OR=14.44,95%CI:3.40~80.82,P=0.001)和肿瘤世界卫生组织(WHO)分级高级别(OR=14.45,95%CI:3.41~80.82,P=0.001)是重度PTBE的影响因素.多因素logistic回归分析显示,ANXA2高表达(OR=19.48,95%CI:2.88~253.96,P=0.007)和肿瘤WHO分级高级别(OR=19.15,95%CI:2.91~233.86,P=0.006)为重度PTBE的独立危险因素,而男性、确诊时年龄≥45岁、肿瘤最大直径>5 cm以及异柠檬酸脱氢酶突变等并非其影响因素(均P>0.05).PTBE区ANXA2的IHC评分与EI呈线性正相关(r=0.72,P<0.001).结论PTBE区ANXA2高表达的成人型弥漫性脑胶质瘤患者发生重度PTBE的风险高,PTBE程度随着ANXA2表达水平升高而加重.
Objective To explore the relationship between the expression of annexin A2(ANXA2)and peritumoral brain edema(PTBE)in adult-type diffuse cerebral gliomas.MethodsThe clinical data of 42 patients with adult-type diffuse gliomas who underwent tumor resection at the Department of Neurosurgery,Peking University Third Hospital from June 2020 to August 2021 were retrospectively analyzed.All patients were classified into mild,moderate and severe PTBE types according to edema index(EI)measured by preoperative head MRI.The expression of ANXA2 in PTBE region was detected by immunohistochemical staining(IHC),and the IHC score was calculated.Patients were divided into high expression group(IHC score≥6)and low expression group(IHC score<6)to compare the degree of PTBE between the two groups.Univariate and multivariate logistic regression analysis and Spearman correlation analysis were used to evaluate the relationship between ANXA2 and PTBE degree.ResultsThe degree of PTBE was significantly different between ANXA2 high expression group(n=26)and ANXA2 low expression group(n=16)(P=0.001),and the proportion of severe edema was higher in ANXA2 high expression group.The univariate logistic regression analysis showed that highly-expressed ANXA2(OR=14.44,95%CI:3.40-80.82,P=0.001)and high grade of World Health Organization(WHO)glioma grade(OR=14.45,95%Cl:3.41-80.82,P=0.001)were the influencing factors of severe PTBE.Multivariate logistic regression analysis confirmed that highly-expressed ANXA2(OR=19.48,95%CI:2.88-253.96,P=0.007)and high grade of WHO glioma classification(0R=19.15,95%CI:2.91~233.86,P=0.006)were independent risk factors for severe PTBE,while male,age at diagnosis≥45 years old,maximum diameter of tumor>5 cm,IDH mutation status or others were not influencing factors(P>0.05).EI was correlated with the IHC score of ANXA2 in a positive linear correlation(r=0.72,P<0.05).ConclusionsAdult-type diffuse glioma patients with high expression of ANXA2 in the PTBE region have a high risk of severe PTBE,and the degree of PTBE incr
作者
马凯明
杨军
马长城
陈素华
陈新
孙建军
杨辰龙
Ma Kaiming;Yang Jun;Ma Changcheng;Chen Suhua;Chen Xin;Sun Jianjun;Yang Chenlong(Department of Neurosurgery,Peking University Third Hospital,Bejing 100191,China;Center for Precision Neurosurgery and Oncology of Peking University Health Science Center,Bejing 100191,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2022年第12期1231-1236,共6页
Chinese Journal of Neurosurgery
基金
国家自然科学基金(82072774,81872051)
北京大学临床科学家计划(BMU2019LCKXJ007)
北京大学第三医院临床重点项目(BYSY2018060)。
