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脑肿瘤患者 8 种循环血浆标志物的探索性研究。

Exploratory investigation of eight circulating plasma markers in brain tumor patients.

机构信息

Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

出版信息

Neurosurg Rev. 2013 Jan;36(1):45-55; discussion 55-6. doi: 10.1007/s10143-012-0401-6. Epub 2012 Jul 5.

Abstract

Several blood biomarkers have been established for the early diagnosis, screening and follow-up of non central nervous system cancers. However, there is lack of knowledge on biochemical blood alterations in brain tumor patients. In this study, we prospectively collected blood plasma samples of 105 adult brain tumor patients with diffuse low-grade glioma (World Health Organization (WHO) II, n = 7), anaplastic glioma (WHO III, n = 10), glioblastoma multiforme (WHO IV, glioblastoma multiforme (GBM)) (n = 34), meningioma (WHO I, n = 8), atypical meningioma (WHO II, n = 5), and intracerebral metastasis (ICM; n = 41). In each case, we measured plasma concentrations of neuropeptide Y, brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, placental growth factor (PlGF), S100B, secretagogin, interleukin 8, and glial fibrillary acidic protein (GFAP) using enzyme-linked immunosorbent assay. Plasma marker concentrations were correlated to patient parameters including neuropathological diagnosis and neuroradiological features. Most of the markers were detectable in all diagnostic categories in variable concentrations. GFAP plasma detectability was strongly associated with a diagnosis of GBM (p < 0.001). Plasma GFAP and plasma placental growth factor showed promising moderate potential in the differential diagnosis of unifocal GBM versus unifocal supratentorial ICM (area under the curve = 0.73, p < 0.05). To summarize, our data show that none of the investigated markers is suitable to substitute histological diagnosis. However, measurement of circulating GFAP and PlGF may support neuroradiological differential diagnosis of GBM versus ICM.

摘要

已有几种血液生物标志物被确立用于非中枢神经系统癌症的早期诊断、筛查和随访。然而,对于脑瘤患者的生化血液改变,我们知之甚少。在这项研究中,我们前瞻性地收集了 105 例成年脑瘤患者的血浆样本,其中弥漫性低级别胶质瘤(世界卫生组织(WHO)II 级,n=7)、间变性神经胶质瘤(WHO III 级,n=10)、胶质母细胞瘤多形性(WHO IV 级,胶质母细胞瘤多形性(GBM))(n=34)、脑膜瘤(WHO I 级,n=8)、非典型脑膜瘤(WHO II 级,n=5)和颅内转移瘤(ICM;n=41)。在每种情况下,我们使用酶联免疫吸附试验测量了神经肽 Y、脑源性神经营养因子、胶质细胞系源性神经营养因子、胎盘生长因子(PlGF)、S100B、分泌素、白细胞介素 8 和神经胶质纤维酸性蛋白(GFAP)的血浆浓度。将血浆标志物浓度与包括神经病理学诊断和神经放射学特征在内的患者参数相关联。大多数标志物在所有诊断类别中均以不同浓度可检测到。GFAP 血浆可检测性与 GBM 的诊断强烈相关(p<0.001)。血浆 GFAP 和血浆胎盘生长因子在鉴别诊断单侧 GBM 与单侧幕上 ICM 方面具有中等潜力(曲线下面积=0.73,p<0.05)。总之,我们的数据表明,没有一种研究标志物适合替代组织学诊断。然而,循环 GFAP 和 PlGF 的测量可能有助于 GBM 与 ICM 的神经放射学鉴别诊断。

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