Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2023; 11(14): 3158-3166
Published online May 16, 2023. doi: 10.12998/wjcc.v11.i14.3158
Changes and significance of serum ubiquitin carboxyl-terminal hydrolase L1 and glial fibrillary acidic protein in patients with glioma
Qing-Hua Zhu, Jing-Kun Wu, Gao-Lei Hou
Qing-Hua Zhu, Jing-Kun Wu, Gao-Lei Hou, Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, Handan 056002, Hebei Province, China
Author contributions: Zhu QH and Wu JK designed the study, and implemented and collected the data; Zhu QH analyzed the data, wrote and edited the manuscript; and Hou GL supervised and supported the research.
Supported by Hebei Medical Science Research Project, No. 20220648.
Institutional review board statement: This study was approved by the Ethics Committee of the Affiliated Hospital of Hebei Engineering University.
Informed consent statement: All study participants or their legal guardians provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Kun Wu, MM, Associate Chief Physician, Department of Neurosurgery, Affiliated Hospital of Hebei Engineering University, No. 81 Congtai Street, Congtai District, Handan 056002, Hebei Province, China. wujingkunwjk@163.com
Received: February 19, 2023
Peer-review started: February 19, 2023
First decision: February 28, 2023
Revised: March 17, 2023
Accepted: April 6, 2023
Article in press: April 6, 2023
Published online: May 16, 2023
Processing time: 85 Days and 23.1 Hours
Abstract
BACKGROUND

Brain gliomas are malignant tumors with high postoperative recurrence rates. Early prediction of prognosis using specific indicators is of great significance.

AIM

To assess changes in ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) levels in patients with glioma pre-and postoperatively.

METHODS

Between June 2018 and June 2021, 91 patients with gliomas who underwent surgery at our hospital were enrolled in the glioma group. Sixty healthy volunteers were included in the control group. Serum UCH-L1 and GFAP levels were measured in peripheral blood collected from patients with glioma before and 3 d after surgery. UCH-L1 and GFAP levels in patients with glioma with different clinicopathological characteristics were compared before and after surgery. The patients were followed-up until February 2022. Postoperative glioma recurrence was recorded to determine the serum UCH-L1 and GFAP levels, which could assist in predicting postoperative glioma recurrence.

RESULTS

UCH-L1 and GFAP levels in patients with glioma decreased significantly 3 d after surgery compared to those before therapy (P < 0.05). However, UCH-L1 and GFAP levels in the glioma group were significantly higher than those in the control group before and after surgery (P < 0.05). There were no statistically significant differences in preoperative serum UCH-L1 and GFAP levels among patients with glioma according to sex, age, pathological type, tumor location, or number of lesions (P > 0.05). Serum UCH-L1 and GFAP levels were significantly lower in the patients with WHO grade I-II tumors than in those with grade III-IV tumors (P < 0.05). Serum UCH-L1 and GFAP levels were lower in the patients with tumor diameter ≤ 5 cm than in those with diameter > 5 cm, in which the differences were statistically significant (P < 0.05). Glioma recurred in 22 patients. The preoperative and 3-d postoperative serum UCH-L1 and GFAP levels were significantly higher in the recurrence group than these in the non-recurrence group (P < 0.05). Receiver operating characteristic curves were plotted. The areas under the curves of preoperative serum UCH-L1 and GFAP levels for predicting postoperative glioma recurrence were 0.785 and 0.775, respectively. However, the efficacy of serum UCH-L1 and GFAP levels 3 d after surgery in predicting postoperative glioma recurrence was slightly lower compared with their preoperative levels.

CONCLUSION

UCH-L1 and GFAP efficiently reflected the development and recurrence of gliomas and could be used as potential indicators for the recurrence and prognosis of glioma.

Keywords: Glioma; Ubiquitin carboxy-terminal hydrolase L1; Glial fibrillary acidic protein; Surgery; Prognosis; Clinical significance

Core Tip: Since the recurrence rate of glioma is high, it is important to early predict its prognosis. Ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) are important markers for nervous system damages and lesions. Therefore, we evaluated the changes in UCH-L1 and GFAP levels in patients with glioma during the perioperative period and compared them with those in healthy volunteers to analyze their relationship with clinicopathological and postoperative recurrence. These results revealed that UCH-L1 and GFAP might reflect the development and recurrence of glioma and could be used as potential indicators to estimate prognosis of glioma.