关键词:  , 脑胶质瘤；围术期；血清高迁移率族B1蛋白；基质金属蛋白酶-9；颅内感染

Abstract:

Objective： To explore the changes of perioperative levels of serum high mobility group box1 protein （HMGB1） and matrix metalloproteinase-9 （MMP-9） in patients with glioma and their relationship with postoperative intracranial infection.Methods： 115 patients with glioma who underwent tumor resection in our hospital during July 2020 and January 2022 were selected. According to the glioma grading system， the patients were divided into the low-grade group （56 cases， grade I-II） and the high-grade group （59 cases， grade III-IV）. The perioperative serum HMGB1 and MMP-9 levels of the two groups of patients were compared. The patients were classified into the infected group （21 cases） and the un-infected group （94 cases） according to postoperative intracranial infection. Multivariate Logistic regression analysis was used to analyze the risk factors for postoperative intracranial infection in patients with glioma， and receiver operating characteristic （ROC） curve was drawn to evaluate the diagnostic value of serum HMGB1 and MMP-9 levels on postoperative intracranial infection in patients with glioma.Results： Compared with before surgery， the levels of serum HMGB1 and MMP-9 of patients in the two groups increased at 1 d and 7 d after surgery （P<0.05）， and the levels of serum HMGB1 and MMP-9 of patients in the high-grade group were higher than those in the low-grade group （P<0.05）. The proportions of patients age >65 years old， with diabetes mellitus， pathological stage III-IV and surgical time >6 h in the infected group were higher than those in the uninfected group （P<0.05）. Multivariate Logistic regression analysis showed that age >65 years old and pathological stage III-IV were risk factors for postoperative intracranial infection in patients with glioma （P<0.05）. The levels of serum HMGB1 and MMP-9 of patients in the infected group were higher than those in the uninfected group at 1 d and 7 d after surgery （P<0.05）. The area under the curve （AUC） of serum HMGB1 combined with MMP-9 was 0.875 in assessing postoperative intracranial infection， with the sensitivity of 90.48% and the specificity of 73.40%.Conclusion： The levels of serum HMGB1 and MMP-9 in patients with high-grade glioma are significantly higher than those in low-grade patients， and the high expressions of serum HMGB1 and MMP-9 in postoperative patients are closely related to intracranial infection. Detecting serum HMGB1 and MMP-9 reveis can be used to evaluate the postoperative intracranial infection in glioma patients.

Key words: Glioma； , Perioperative period； , Serum high mobility group box1 protein； , Matrix metalloproteinase-9； , Intracranial infection