血浆IGFBP-2在脑胶质母细胞瘤治疗前后变化

目的 探讨脑胶质瘤病人血浆类胰岛素样生长因子结合蛋白2(insulin-like growthfactor binding protein 2,IGFBP-2)浓度动态监测在病人病情判定、预测复发中的临床意义.方法 用酶联免疫法(ELISA)对健康体检者、不同级别胶质瘤及胶质母细胞瘤病人综合治疗后复发前后血浆IGFBP-2浓度进行统计学比较,随访其中55例胶质母细胞瘤病人2.5年,分析术前血浆IGFBP-2的浓度与其无瘤生存期的关系.结果 血浆IGFBP-2浓度随着胶质瘤级别的升高而增加(F=17.745,P=0.000);胶质母细胞瘤病人经过手术、放疗、化疗综合治疗后,未复发病人血浆IGFBP-2明显下降(t=2.164,P=0.041),而复发后明显升高(t=8.295,P=0.000);血浆中IGFBP-2浓度<600ng/ml的脑胶质母细胞瘤病人的无瘤生存期明显长于浓度>600ng/ml的胶质母细胞瘤病人(Z=2.272,P=0.023).结论 血浆IGFBP-2浓度的动态监测对判定胶质瘤病人病变恶性程度、预测胶质母细胞瘤的复发有一定的临床意义.

Variation of plasma IGFBP-2 level in patients with glioblastoma after combined therapy

Objective To investigate the clinical significance of detecting insulin like growth factor binding protein 2 (IGFBP-2) in the plasma of patients with glioma in judging glioma grade, predicting glioma recurrence. Method The plasma IGFBP-2 level was measured by enzyme linked immunosorbent assay ( ELISA ) in 51 cases with WHO 2 glioma, 26 cases with anaplasia glioma, 56 cases with glioblastoma, 30 cases with anaplasia glioma, 56 cases with glioblastoma, 30 healthy controls, and patients with glioblastoma before and after receiving combined therapy. Meanwhile, analyse the relation of plasma IGFBP-2 level and patients'survival without glioma recurrence in patients with glioblastoma after receiving combined therapy. One-way ANOVA, LSD, independent-samples t test, paired-samples t test and Kaplan-Meier were used to analyse the IGFBP-2 level between different groups. Results The plasma IGFBP-2 level in patients with high-grade glioma was significantly higher than low-grade glioma and healthy controls ( F =17.745 ,P =0.000) ; the plasma IGFBP-2 level in patients with glioblastoma was decreased after receiving combined therapy( t = 2. 164, P = 0. 041 ). While it rising significantly in patience with glioblastoma recurrence after receiving combined therapy (t =8. 295 ;P =0.000) ; the patients with lower plasma IGFBP-2 (<600ng/ml) level had longer survival time without glioma recurrence than those with plasma IGFBP-2 level ( > 600ng/ml) ( Z = 2.272, P = 0.023 ). Conclusion The dynamic detection of IGFBP-2 level in the plasma of patients with glioma was helpful to judging pathogenetic condition , predicting glioma recurrence.