Sitter Beathe, Forsmark Annamaria, Solheim Ole
Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Anaesthesia and Intensive Care, Nord-Trondelag Health Trust, Levanger, Norway.
Front Oncol. 2022 May 19;12:831079. doi: 10.3389/fonc.2022.831079. eCollection 2022.
Serum lactate levels in brain cancer patients correlate with tumor malignancy grading, and serum lactate has been suggested as a potential biomarker and prognostic factor. The purpose of this study was to identify potential sources of elevated serum lactate in patients with brain gliomas by examining factors of importance for serum lactate production and clearance.
In this cross-sectional study, data were collected from 261 glioma patients who underwent surgery from March 2011 to June 2015. We recorded patient gender, age, blood serum measures of lactate, glucose, pH, hemoglobin and base excess, patient health status, medications, and tumor characteristics. Patients with elevated and normal serum lactate levels were compared, and we explored if there were correlations between the variables. The association of serum lactate with the measured variables was investigated by simple and multivariable linear regression models.
Patients with elevated serum lactate had higher blood glucose, larger tumor volumes, and more tumor edema; more often needed pressor medication during surgery; and more often received corticosteroid treatment. The investigated variables were highly correlated. Multivariable linear regression indicated that gender, tumor volume, Charlson Comorbidity Index, hyperglycemia, and corticosteroid treatment were associated with serum lactate levels. Histopathology was not an independent factor. In conclusion, comorbidities, hyperglycemia, and presurgical corticosteroid treatment exhibited the strongest association with serum lactate in glioma patients.
脑癌患者的血清乳酸水平与肿瘤恶性程度分级相关，血清乳酸已被认为是一种潜在的生物标志物和预后因素。本研究的目的是通过检查对血清乳酸产生和清除重要的因素，确定脑胶质瘤患者血清乳酸升高的潜在来源。
在这项横断面研究中，收集了2011年3月至2015年6月接受手术的261例胶质瘤患者的数据。我们记录了患者的性别、年龄、血清乳酸、葡萄糖、pH值、血红蛋白和碱剩余的测量值、患者健康状况、用药情况以及肿瘤特征。对血清乳酸水平升高和正常的患者进行了比较，并探讨了变量之间是否存在相关性。通过简单和多变量线性回归模型研究血清乳酸与测量变量之间的关联。
血清乳酸水平升高的患者血糖更高、肿瘤体积更大、肿瘤水肿更严重；手术期间更常需要使用升压药物；更常接受皮质类固醇治疗。所研究的变量高度相关。多变量线性回归表明，性别、肿瘤体积、查尔森合并症指数、高血糖和皮质类固醇治疗与血清乳酸水平相关。组织病理学不是一个独立因素。总之，合并症、高血糖和术前皮质类固醇治疗与胶质瘤患者血清乳酸的关联最为密切。
