中文摘要：

目的 探讨人脑胶质瘤脑脊液中期因子（MK）水平与胶质瘤病理学的关系。方法 2015年5~10月手术治疗并经病理证实的胶质瘤25例，其中高级别胶质瘤（WHO Ⅲ~Ⅳ级）10例，低级别胶质瘤（WHO Ⅰ~Ⅱ级）15例。同期手术切除颅内良性肿瘤23例，非肿瘤性颅脑手术18例。酶联免疫吸附试验法检测所有病人术中以及脑胶质瘤术后腰椎穿刺术留取的脑脊液MK水平。免疫组化染色法分析胶质瘤组织MK表达水平。结果 胶质瘤组脑脊液MK浓度明显高于良性肿瘤组（P〈0.001）和非肿瘤组（P〈0.001），高级别胶质瘤脑脊液MK浓度显著高于低级别胶质瘤（P〈0.05）；胶质瘤组织MK阳性程度与脑脊液MK的浓度呈显著正相关（r=0.75；P〈0.001）。根据受试者工作特征曲线，脑脊液MK浓度〉2.55 ng/ml区分胶质瘤和非肿瘤的敏感性和特异性分别为72.0%和83.3%。脑脊液MK浓度〉2.11 ng/ml区分胶质瘤和良性肿瘤的敏感性和特异性为76.0%和82.6%。术后7~14 d，脑胶质瘤病人脑脊液MK水平[（2.22±1.23） ng/ml]显著下降（P〈0.05）。结论 胶质瘤级别越高，肿瘤组织和脑脊液MK表达水平越高；切除肿瘤后脑脊液MK随之下降；脑脊液MK对术前诊断胶质瘤的具有较高的敏感性和特异性，同时对手术效果的评价也有重要意义。

英文摘要：

Objective To investigate the expression of midkine （MK） in cerebrospinal fluid （CSF） and its relationship with clinicopathological features in patients with gliomas. Methods The level of MK in CSF were determined by enzyme linked immunosorbent assay in 25 patients with gliomas including WHO grades Ⅰ~Ⅱ gliomas （15 cases） and WHO grades Ⅲ~Ⅳ gliomas （10 cases）, 23 patients with benign tumors and 18 patients with other lesions including communicating hydrocephalus （10 cases） and trigeminal neuralgia （8 cases）. The MK expression were detected by immunohistochemical technique in 25 glioma patients after operative. Results The level of MK expression in CSF with gliomas was significantly higher in the patients with gliomas than those in the patients with benign tumors and non-neoplasms （P〈0.001）. The level [（7.02±4.62） ng/ml] of MK in CSF was significantly higher in the patients with WHO grades Ⅲ~Ⅳ gliomas than that [（3.20±1.84） ng/ml] in the patients with WHO grades Ⅰ~Ⅱ gliomas （P〈0.05）. The level of MK expression in CSF was positively related with that in the tumorous tissues in the patients with gliomas （r=0.751, P〈0.001）. The level of MK expression in CSF significantly declined from 7 to 14 days after the resection of tumors compared to that before the operation in the patients with gliomas （P〈0.05）. Conclusion It is suggested that the level of MK in CSF may be helpful to the diagnosis of human gliomas.