Relationship between serum sTIM-3 and its ligand Gal-9, CEACAM-1 and the degree of brain injury and prognosis in patients with traumatic brain injury

doi:10.3877/cma.j.issn.2095-123X.2024.04.002

Abstract

Abstract:

Objective

To explore the relationship between serum levels of soluble T cell immunoglobulin and mucin domain-3 (sTIM-3), and its ligand Galectin-9 (Gal-9) and carcinoembryonic antigen-related cell adhesion molecule-1 (CEACAM-1) in patients with traumatic brain injury (TBI) and the degree of brain injury and prognosis.

Methods

A total of 120 patients with TBI admitted to the Third Department of Neurosurgery of Handan Central Hospital from February 2022 to February 2023 were selected as the observation group, and 120 healthy subjects who underwent physical examination during the same period were selected as the control group.The levels of sTIM-3, Gal-9 and CEACAM-1 were compared between the two groups.The TBI patients were graded according to the preoperative GCS score (severe type, moderate type and mild type), and the differences of serum sTIM-3, Gal-9 and CEACAM-1 levels in patients with different TBI degrees were explored.After 1 month of treatment, the prognosis of TBI patients was evaluated according to the GOS score.Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in TBI patients.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of the influencing factors on the prognosis of TBI patients.

Results

In the observation group, there were 36 cases of severe type, 42 cases of moderate type and 42 cases of mild type.Compared with the control group, the levels of sTIM-3, Gal-9 and CEACAM-1 in the observation group increased, and the expression level increased with the increase of TBI degree, the differences were statistically significant (P＜0.05).After 1 month of treatment, 76 cases had good prognosis and 44 cases had poor prognosis.Univariate analysis showed that the levels of serum sTIM-3,Gal-9,CEACAM-1 and GCS score in patients with poor prognosis were higher than those in patients with good prognosis (P＜0.05).Multivariate Logistic regression analysis showed that sTIM-3, Gal-9, CEACAM-1 and GCS score were independent factors affecting the prognosis of TBI patients (P＜0.05).ROC analysis showed that the area under the curve (95%CI) of serum sTIM-3,Gal-9, CEACAM-1 and GCS score alone and in combination were 0.744, 0.706, 0.697, 0.739 and 0.823(0.724-0.921), respectively, the diagnostic efficiency of combined application was higher than that of each index alone (P＜0.05).

Conclusion

Serum sTIM-3 and its ligands Gal-9 and CEACAM-1 can be used as new and meaningful molecular markers to evaluate the severity and prognosis of TBI patients.

Key words: Traumatic brain injury, Soluble T - cell immunoglobulin and mucin - domain containing-3, Galectin-9, Carcinoembryonic antigen-related cell adhesion molecule-1, Degree of brain injury; Prognosis

Zhiheng Hu, Hongbo Ren, Zhiyuan Song, Yungang Zhao, Xiaozheng Han. Relationship between serum sTIM-3 and its ligand Gal-9, CEACAM-1 and the degree of brain injury and prognosis in patients with traumatic brain injury[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2024, 14(04): 201-207.

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References 27

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组别	例数	sTIM-3	Gal-9	CEACAM-1
观察组	120	2.62（1.65，3.89）	2.28（1.14，3.02）	20.53（15.42，25.38）
对照组	120	1.68（1.20，3.18）	1.50（1.15，2.87）	18.96（15.32，21.94）
U值		4.227	3.935	2.346
P值		＜0.001	＜0.001	0.019

组别	例数	sTIM-3	Gal-9	CEACAM-1
观察组	120	2.62（1.65，3.89）	2.28（1.14，3.02）	20.53（15.42，25.38）
对照组	120	1.68（1.20，3.18）	1.50（1.15，2.87）	18.96（15.32，21.94）
U值		4.227	3.935	2.346
P值		＜0.001	＜0.001	0.019

脑损伤程度		例数	sTIM-3	Gal-9	CEACAM-1
轻型		42	2.53（1.65，2.61）	1.98（1.14，2.46）	18.47（14.31，23.04）
中型		42	2.71（1.67，3.26）	2.19（1.18，2.65）	19.94（14.56，22.31）
重型		36	2.83（1.70，3.89）	2.31（1.30，3.02）	22.08（15.73，25.38）
差异检验	H值		7.907	9.976	6.607
	P值		0.019	0.007	0.037
趋势检验	χ ²值		6.229	6.350	7.477
	P值		0.044	0.042	0.024

脑损伤程度		例数	sTIM-3	Gal-9	CEACAM-1
轻型		42	2.53（1.65，2.61）	1.98（1.14，2.46）	18.47（14.31，23.04）
中型		42	2.71（1.67，3.26）	2.19（1.18，2.65）	19.94（14.56，22.31）
重型		36	2.83（1.70，3.89）	2.31（1.30，3.02）	22.08（15.73，25.38）
差异检验	H值		7.907	9.976	6.607
	P值		0.019	0.007	0.037
趋势检验	χ ²值		6.229	6.350	7.477
	P值		0.044	0.042	0.024

因素	预后良好（n=76）	预后不良（n=44）	χ ²/t/U值	P值	OR值	95%CI
性别[例（%）]			0.186	0.666	0.785	0.463～1.315
女	25（48.08）	27（51.92）
男	30（48.11）	38（55.88）
年龄[例（%）]			0.011	0.916	1.152	0.723～1.826
40～47岁	23（63.64）	35（59.15）
48～53岁	24（36.36）	38（40.85）
损伤类型[例（%）]			0.072	0.965	0.854	0.490～1.476
软组织损伤	17（48.57）	18（51.43）
颅骨损伤	22（45.83）	26（54.17）
颅内组织损伤	17（45.95）	20（54.05）
损伤原因[例（%）]			0.062	0.969	0.907	0.568～1.426
交通事故	31（48.44）	33（51.56）
高空坠落	16（47.06）	18（52.94）
打击伤	10（45.45）	12（54.55）
GCS评分（分，Mean±SD）	12.65±2.18	7.06±2.34	13.176	＜0.001	0.422	0.311～0.573
sTIM-3[ng/mL，M（Q1，Q3）]	2.61（1.65，3.39）	2.79（1.68，3.88）	2.652	0.008	0.948	0.516～1.714
Gal-9[ng/mL，M（Q1，Q3）]	2.01（1.14，2.78）	2.30（1.22，2.89）	2.241	0.025	0.875	0.489～1.550
CEACAM-1[ng/mL，M（Q1，Q3）]	21.09（14.62，25.17）	23.06（15.21，27.12）	2.097	0.036	0.911	0.423～1.960

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