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高敏 C 反应蛋白和白细胞介素 6 在脑胶质瘤和脑膜瘤患者中的预后作用。

Prognostic role of high sensitivity C-reactive protein and interleukin-6 in glioma and meningioma patients.

机构信息

Neuroscience Institute and Department of Neurosurgery, Lithuanian University of Health Sciences, Eiveniu g. 2, 50009, Kaunas, Lithuania.

Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

J Neurooncol. 2018 Jun;138(2):351-358. doi: 10.1007/s11060-018-2803-y. Epub 2018 Feb 19.

Abstract

High sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) can be important prognostic indicators of brain tumor patients. We investigated the association of circulating IL-6 and hsCRP concentrations with discharge outcomes and survival of glioma and meningioma patients. One-hundred and sixty-three (115 women; median age 57 years) patients admitted for meningioma (n = 94), high-grade glioma (n = 48) and low-grade glioma (n = 21) surgery were enrolled in this prospective cohort study. Serum samples were collected within 24 h of admission. Discharge outcome was evaluated using the Glasgow Outcome Scale (unfavorable outcome = score from 1 to 3). Follow-up continued until November, 2016. Elevated IL-6 (≥ 2 pg/ml) and hsCRP (≥ 1 mg/l) concentrations were present in 25 and 35% of brain tumor patients, respectively. Elevated IL-6 concentrations were associated with unfavorable outcome at hospital discharge, adjusting for brain tumor histological diagnosis, patient age and gender (OR 2.39, 95% CI 0.97-5.91, p = 0.05). Elevated hsCRP concentrations were not associated with discharge outcome (p = 0.13). In multivariate Cox regression analyses adjusted for patient age, gender, extent of tumor resection and adjuvant treatment, elevated IL-6 concentration was associated with greater mortality risk in high-grade glioma patients (OR 2.623; 95% CI 1.129-5.597; p = 0.01), while elevated hsCRP concentration was associated with greater mortality risk in meningioma patients (OR 3.650; 95% CI 1.038-12.831; p = 0.04). Elevated IL-6 concentration is associated with greater unfavorable outcome risk in brain tumor patients and with greater mortality in high-grade glioma patients, while elevated hsCRP concentration is associated with greater mortality in meningioma patients.

摘要

高敏 C 反应蛋白(hsCRP)和白细胞介素 6(IL-6)可以作为脑肿瘤患者重要的预后指标。我们研究了循环 IL-6 和 hsCRP 浓度与脑胶质瘤和脑膜瘤患者出院结局和生存的关系。本前瞻性队列研究纳入了 163 名(115 名女性;中位年龄 57 岁)因脑膜瘤(n=94)、高级别胶质瘤(n=48)和低级别胶质瘤(n=21)手术而入院的患者。在入院后 24 小时内采集血清样本。使用格拉斯哥预后量表(不良结局=评分 1-3)评估出院结局。随访至 2016 年 11 月。分别有 35%和 25%的脑肿瘤患者存在 IL-6(≥2pg/ml)和 hsCRP(≥1mg/l)浓度升高。在校正脑肿瘤组织学诊断、患者年龄和性别后,IL-6 浓度升高与出院时不良结局相关(OR 2.39,95%CI 0.97-5.91,p=0.05)。hsCRP 浓度升高与出院结局无关(p=0.13)。在校正患者年龄、性别、肿瘤切除范围和辅助治疗后,多变量 Cox 回归分析显示,IL-6 浓度升高与高级别胶质瘤患者的死亡率风险增加相关(OR 2.623;95%CI 1.129-5.597;p=0.01),而 hsCRP 浓度升高与脑膜瘤患者的死亡率风险增加相关(OR 3.650;95%CI 1.038-12.831;p=0.04)。IL-6 浓度升高与脑肿瘤患者不良结局风险增加相关,与高级别胶质瘤患者死亡率增加相关,而 hsCRP 浓度升高与脑膜瘤患者死亡率增加相关。

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