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用于预测择期神经外科手术后结局的循环性脑损伤生物标志物:范围综述。

Circulating Brain Injury Biomarkers for Predicting Outcomes Following Elective Neurosurgery: A Scoping Review.

机构信息

Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

World Neurosurg. 2024 Oct;190:434-442.e1. doi: 10.1016/j.wneu.2024.07.192. Epub 2024 Aug 2.

Abstract

OBJECTIVE

There is a need for refined methods to detect and quantify brain injuries that may be undetectable by magnetic resonance imaging and neurologic examination. This review evaluates the potential efficacy of circulating brain injury biomarkers for predicting outcomes following elective neurosurgical procedures.

METHODS

A comprehensive search was conducted using the Cochrane, PubMed, and Scopus databases.

RESULTS

Analysis of 23 relevant studies revealed that specific biomarkers, including glial fibrillary acidic protein, neurofilament light chain, neuron-specific enolase, S100B, and tau, are significantly associated with the extent of brain injury and could potentially predict postsurgical outcomes. The evaluated studies described intracranial tumor surgeries and miscellaneous neurosurgical interventions and demonstrated the complex relationship between biomarker levels and patient outcomes.

CONCLUSIONS

Circulating brain injury biomarkers show promise for providing objective insights into the extent of perioperative brain injury and improving prognostication of postsurgical outcomes. However, the heterogeneity in study designs and outcomes along with the lack of standardized biomarker thresholds underscore the need for further research.

摘要

目的

需要更精细的方法来检测和量化可能无法通过磁共振成像和神经检查检测到的脑损伤。本综述评估了循环性脑损伤生物标志物在预测择期神经外科手术后结果方面的潜在效果。

方法

使用 Cochrane、PubMed 和 Scopus 数据库进行了全面搜索。

结果

对 23 项相关研究的分析表明,特定的生物标志物,包括胶质纤维酸性蛋白、神经丝轻链、神经元特异性烯醇化酶、S100B 和 tau,与脑损伤的程度显著相关,并可能预测术后结果。评估的研究描述了颅内肿瘤手术和各种神经外科干预,并展示了生物标志物水平与患者结果之间的复杂关系。

结论

循环性脑损伤生物标志物有希望为评估围手术期脑损伤的程度提供客观的见解,并改善术后结果的预测。然而,研究设计和结果的异质性以及缺乏标准化的生物标志物阈值突出表明需要进一步的研究。

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