Perioperative Change Of Serum Levels Of NSE, S100B And MBP In Patients Undergoing Intracranial Tumor Resection

Background:Neurosurgical procedures may cause brain injury due to its invasiveness and thus can obstruct patients’recovery process. The basic mission for neurosurgeon is trying to ease surgery invasiveness and protect brain tissue. It is supposed that serum levels of NSE, MBP and S100B are correlated with the extent of brain tissue damage. So they may work for surgical brain injury either. Then they would be helpful in guiding neurosurgeon to choose optimal surgery strategy, feeding back brain injury information and thus help collect experience and improve the skill of neurosurgeon.Objective:To exam the peri-operatively spectrum of serum levels of NSE, MBP and S100B in patients undergoing intracranial tumor resection, in order to evaluate their potential for reflect tumor related brain injury or surgical brain injury.Methods:There is 35 meningioma,41 glioma and 20 acoustic tumor patients recruited. And blood samples were collected for all patients on admission and on postoperative day 1,3 and 7. At the mean time, the patients’ clinical information (such as surgery duration, the grade of WHO classification of tumor, immunohistochemical result of NSE/S100B in tumor, tumor volume measured by MRI, peritumor edema volume and Karnofsky performance scale, etc.) were recorded, too. Besides, blood samples from 33 healthy adults were collected just for once to be a control. Both the serum samples from patients and the control were test for MBP and S100B levels by using a sandwich ELISA assay, while the serum level of NSE was quantified by the clinical laboratory using an electrochemiluminescence immunoassay. The serum levels of NSE, MBP and S100B were compared perioperatively by Repeated measures ANOVA and were made a correlation analysis with patients’ clinical information.Results:1. The preoperative serum levels of NSE among the three brain tumor groups and the control have no difference(P> 0.05). And Repeated measures ANOVA show that the postoperative levels of serum NSE do not change in any groups compared with preoperative levels (P>0.05).2. The preoperative serum levels of S100B between meningiom and glioma group has no difference (P>0.05) and are both higher than the control’s(P< 0.05). One way ANOVA show that serum level of the acoustic tumor group has no difference with the control’s (P> 0.05). The serum levels of S100B in postoperative day 1 and day 3 do not rise compared with the preoperative level(P>0.05), while the levels of postoperative day 7 elevated(P<0.05) in all groups. And the spectrum of such a change is same among the 3 group of tumor.3. There are no difference among the preoperative levels of the three tumor group and the control’s(P>0.05). The serum levels of MBP in postoperative day 1 and day 3 are higher than the preoperative(P<0.05). The postoperative day 7 serum levels of S100B declined (P<0.05) to the preoperative base line levels (P >0.05)in both meningioma and glioma group. Whereas, the postoperative level day 7 of S100B in acoustic tumor group are still higher than the preoperative(P <0.05).4. Correlation analysis:(1) Serum levels of NSE have some negative correlation with surgery duration in meningiom and glioma group(P<0.05) and with preoperative Karnofsky performance scale,volume of peritumor edema, postoperative edema of brain tissue in glioma group(P< 0.05), while it is positive associated volume of glioma(P< 0.05). (2) The positive association between serum S100B and surgery duration was seen in both glioma and acoustic tumor group(P< 0.05). Positive association were also seen in glioma between serum S100B and peritumor edema volume, the WHO grade of glioma(.P< 0.05). While a negative correlation lies between serum S100B and acoustic tumor volume(P< 0.05). (3) Negative correlation were seen in meningioma between serum MBP and preoperative KPS, KPS at discharge(P< 0.05),and also seen in glioma between MBP and preoperative KPS.While positive correlation were seen in glioma group between serum MBP and volume of glioma, volume of peritumor edema and postoperative brain tissue edema, surgery duration, etc(P< 0.05). In acoustic tumor, serum MBP has a negative association with KPS at discharge in postoperative day 1(P< 0.05), and a positive correlation with KPS at discharge in postoperative day 7(P<0.05).Conclusions:1. Serum NSE fail to reflect brain insult caused by tumor or surgery.2. Elevated serum levels of S100B may reflect brain tissue insult caused by tumor, and postoperative S100B levels seem have correlation with its function of Neural Repair and regeneration rather than surgical brain injury.3. Although preoperative serum levels of MBP can not reflect brain insult caused by tumor, it seem be able to reflect the process of surgical brain injury.4. Serum S100B and MBP have relative better correlation than NSE with the WHO grade of glioma, volume of perirtumor edema, postoperative brain tissue edema, surgery duration and KPS;And they may reflect the extent of lesions of brain tissue accordantly. There are some correlations among serum levels of NSE, MBP and clinical data of meningioma and glioma patients, and among serum levels of NSE, S100B and clinical data of acoustic tumor patients; The significance of such correlations are supposed to be further studied.