血清YKL-40水平与胶质瘤病理分级及预后的相关性研究

目的探讨血清YKL-40水平与胶质瘤病理分级及预后的相关性。方法选取诊断为脑胶质细胞瘤并行手术治疗的成年病例68例为胶质瘤组,20例健康体检病人作为对照组,根据术后病理学分级,低度恶性Ⅰ级2例、Ⅱ级17例,高度恶性Ⅲ级15例、Ⅳ级34例。观察生存时间及复发时间,生存时间〈12个月15例,12～24个月15例,〉24个月38例。复发前死亡10例,复发时间〈12个月14例,12～24个月15例,〉24个月未复发29例。术前均抽取静脉血采用酶联免疫吸附试验（ELISA）测定血清YKL-40水平。结果低级别（I级、Ⅱ级）胶质瘤病人血清YKL-40水平与对照组无显著差异（P〉0.05），Ⅳ级胶质瘤病人血清YKL-40水平显著高于其他组（P〈0.05）。生存时间〈12个月和12～24个月的病人血清YKL-40水平显著高于生存时间〉24个月的病人（P〈0.05）。复发病人血清YKL-40水平显著高于未复发者（P〈0.05），12个月内复发的病人血清YKL-40水平显著高于12～24个月复发的病人（P〈0.05）。结论血清YKL-40水平与胶质瘤的病理学分级及预后密切相关，可作为恶性程度及预后的判断指标。

Study of the relationship between the serum YKL-40 levels and pathological grade and prognosis of glioma

Objective To investigate the relationship between the seru~ YKL-40 levels and pathological grade and prognosis of glioma. Methods The serum YKL-40 level was detected by enzyme-linked immunosorbent assay （ELISA） in 68 cases of glioma （glioma group） and 20 healthy subjects （control group）. Of the 68 cases, 2 were in pathological grade Ⅰ, 17 in grade Ⅱ, 15 in grade Ⅲ, and 34 in grade IV. The survival time was 〈12 months in 15 cases, 12-24 months in 15 and 〉24 months in 38. Before recurrence, 10 patients died, the recurrence time was 〈12 months in 14 cases, 12-24 months in 15 and 〉24 months in 29. Results There was no significant difference in serum YKL-40 levels between the low-class （grade Ⅰ - Ⅱ） patients and control group （P 〉0.05）. Meanwhile, the serum YKL-40 level in class IV patients was significantly higher than that in the others （P 〈0.05）. Besides, YKL-40 levels in the patients whose survival time was less than 12 months or from 12 to 24 months were significantly higher than those in the patients whose survival time was longer than 24 months （P,〈0.05）. YKL-40 levels in relapsed patients, especially in the patients relapsed in 12 months, were higher than those ：in the patients without recurrence （P 〈0.05）. The recurrence time was also significantly longer in the patients relapsed in 12 months than in the patients relapsed during 12 to 24 months （P 〈0.05）. Conclusions Serum YKL-40 level is related to the pathological grade and prognosis of glioma, and can be considered as the indicators for judging the malignancy grade and prognosis.