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