脑肿瘤切除术前后血清S100B蛋白水平的改变

目的研究脑肿瘤手术前后血清S100B蛋白水平的改变,并分析其与患者临床资料的相关性,评估血清S100B对术后脑损伤的反映能力。方法 30例胶质瘤、28例脑膜瘤和15例听神经瘤患者于手术前(入院时)、手术后第1 d、第3 d、第7 d分别采集血清;同时记录患者手术时长、肿瘤WHO级别、肿瘤体积、脑水肿体积、KPS等临床资料。设正常对照组33例,采集单次血清。用双抗体夹心法ELISA检测血清S100B含量。将手术前后血清S100B水平进行重复测量方差分析;将血清S100B水平与手术时长、肿瘤体积等临床资料进行相关性分析。结果术前血清S100B水平在各脑肿瘤组之间的差异无统计学意义(P0.05),胶质瘤组、脑膜瘤组则高于正常对照组(均P0.05)。术后第1 d、第3 d血清S100B含量无明显改变(P0.05),术后第7 d时高于手术前水平(P0.05),这种趋势在3个脑肿瘤组之间并无差别。在胶质瘤组中,术后第3、7 d血清S100B含量与术后脑水肿体积呈正相关(均P0.05);术后第1 d、第3 d血清S100B含量与胶质瘤病理级别呈正相关(均P0.05)。在听神经瘤组中,手术前、术后第3 d血清S100B含量与听神经瘤肿瘤体积呈负相关(均P0.05),术后第7 d血清S100B水平与手术时长呈正相关(P0.05)。脑膜瘤组内未见任何相关性。结论血清S100B对脑肿瘤切除术后的脑损伤反映较差,其含量升高可能与损伤后神经修复活动有关。血清S100B含量与胶质瘤的病理级别、术后脑水肿程度有一定的相关性,与听神经瘤体积及手术时长存在相关性。脑肿瘤术前血清S100B升高可能反映了肿瘤对脑实质的压迫损伤。

Perioperative serum level of S100B in patients undergoing brain tumor resection

Objective Brain tumor resection could cause brain damage and may affect patient's prognosis .It is supposed that S 100 B level may reflect the extend of brain insults .In this study , we explore how serum S100B changes perioperatively and whether it correlate with patient's clinical data (such as tumor volume , duration of operation, etc.).Method There is 30 glioma patients, 28 meningiomas and 15 acoustic tumor patients included .All patient's blood sample were collected on admission and at postoperative day 1, 3 and 7.And the patient's clinical data ( such as tumor volume , peritumor edema , grading by WHO classification , duration of operation , patient's Karnofsky Performance Scale , etc.) were recorded at the mean time .There is also 33 healthy adults from the medical examination center of the same hospital to be a control group and whose blood sample were collect just for once .We use a commercial ELISA kit to quantify serum level of S 100B. A repeated measure ANOVA is conduct to test among previous and post operative serum levels of S100B.And correlation analysis was made between serum S 100B and patients clinical data .Result The S100 B serum levels among glioma , meningioma and acoustic tumor patients has no statistically difference(P>0.05),and levels of S100B in both glioma and meningioma patients are higher than the control's(all P<0.05), except for the acoustic tumor group's.There is no difference among the three groups in perioperative change of serum S 100B ( P >0.05 ): Serum S100B levels in post operatively day 1 and day 3 has no change compared to its previous operative levels ( P>0 .05 ) , while serum S100B levels in post operatively day 7 is higher than the previous operative levels ( P<0.05).The correlation between post operative brain edema and serum S 100B is seen in the glioma patients in postoperative day 3 and 7 ( all P<0 .05 ) and between the grade of WHO classification of tumor and serum S100B is seen in glioma patients in postoperative day 1 and 3(all P<0.05).In the acoustic tumor patients , there were correlation between postoperative day 7 serum levels of S100B and surgery duration(all P<0.05), and between previous, postoperative day 3 serum levels of S100 B and acoustic tumor volume ( P<0 .05 ) .There is no any correlation in meningioma patients (P>0.05).Conclusion Serum S100B is poor in evaluating brain damage caused by intracranial resection , its post operative elevation may imply the neural repairment course after brain damage . There are some correlation among serum S 100 B and WHO grade and the extend of postoperative edema in glioma, so is among tumor volume and surgery duration in acoustic tumor .Glioma, meningioma could cause serum levels of S 100B increase which may reflect brain damage related with tumor expansive growth .