Department of Critical Care Medicine, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.
Department of Neurosurgery, First Affiliated Hospital of Baotou Medical College, Baotou 014010, Inner Mongolia Autonomous Region, China.
Dis Markers. 2020 Aug 19;2020:8813535. doi: 10.1155/2020/8813535. eCollection 2020.
Cerebral edema is a common complication of brain tumors in the perioperative period. However, there is currently no reliable and convenient method to evaluate the extent of brain edema. The objective is to explore the effectiveness of serum occludin on predicting the extent of perioperative brain edema and outcome in patients with brain tumors.
This prospective study enrolled 55 patients with brain tumors and 24 healthy controls in Sanbo Brain Hospital from June 2019 through November 2019. Serum occludin levels were measured preoperatively and on postoperative day 1. Peritumoral edema was assessed preoperatively using MRI. Pericavity brain edema on postoperative day 1 was evaluated using CT.
Compared with healthy controls, the serum occludin level was higher in patients with brain tumors both preoperatively and postoperatively ( < 0.001). The serum occludin level correlated positively with the degree of brain edema preoperatively ( = 0.78, < 0.001) and postoperatively ( = 0.59, < 0.001). At an optimal cutoff of 3.015 ng/mL, the preoperative serum occludin level discriminated between mild and severe preoperative brain edema with a sensitivity of 90.48% and specificity of 84.62%. At an optimal cutoff value of 3.033 ng/mL, the postoperative serum occludin level distinguished between mild and severe postoperative brain edema with a sensitivity of 97.30% and specificity of 55.56%.
The serum occludin level is associated with cerebral edema and could potentially be used as a biomarker for perioperative cerebral edema. This trial is registered with ChiCTR1900023742.
脑水肿是脑瘤围手术期的常见并发症。然而，目前尚无可靠、方便的方法来评估脑水肿的程度。本研究旨在探讨血清紧密连接蛋白（occludin）预测脑瘤患者围手术期脑水肿程度和结局的有效性。
本前瞻性研究纳入 2019 年 6 月至 2019 年 11 月于首都医科大学三博脑科医院的 55 例脑瘤患者和 24 名健康对照者。分别于术前和术后第 1 天检测血清 occludin 水平。术前采用 MRI 评估瘤周水肿，术后第 1 天采用 CT 评估瘤腔周围脑水肿。
与健康对照组相比，脑瘤患者术前和术后的血清 occludin 水平均较高（均<0.001）。血清 occludin 水平与术前（ =0.78，<0.001）和术后（ =0.59，<0.001）脑水肿程度呈正相关。术前血清 occludin 水平最佳截断值为 3.015ng/ml 时，对轻、重度术前脑水肿的诊断具有较高的灵敏度（90.48%）和特异度（84.62%）。术后血清 occludin 水平最佳截断值为 3.033ng/ml 时，对轻、重度术后脑水肿的诊断具有较高的灵敏度（97.30%）和特异度（55.56%）。
血清 occludin 水平与脑水肿相关，可能可作为预测围手术期脑水肿的生物标志物。本研究已在 ChiCTR1900023742 注册。
