OBJECTIVE Cerebral edema is a common complication of brain tumors in the perioperative period. However, there is currently no reliable and convenient method to evaluate the extent of brain edema. The objective is to explore the effectiveness of serum occludin on predicting the extent of perioperative brain edema and outcome in patients with brain tumors. METHODS This prospective study enrolled 55 patients with brain tumors and 24 healthy controls in Sanbo Brain Hospital from June 2019 through November 2019. Serum occludin levels were measured preoperatively and on postoperative day 1. Peritumoral edema was assessed preoperatively using MRI. Pericavity brain edema on postoperative day 1 was evaluated using CT. RESULTS Compared with healthy controls, the serum occludin level was higher in patients with brain tumors both preoperatively and postoperatively (P < 0.001). The serum occludin level correlated positively with the degree of brain edema preoperatively (r = 0.78, P < 0.001) and postoperatively (r = 0.59, P < 0.001). At an optimal cutoff of 3.015 ng/mL, the preoperative serum occludin level discriminated between mild and severe preoperative brain edema with a sensitivity of 90.48% and specificity of 84.62%. At an optimal cutoff value of 3.033 ng/mL, the postoperative serum occludin level distinguished between mild and severe postoperative brain edema with a sensitivity of 97.30% and specificity of 55.56%. CONCLUSIONS The serum occludin level is associated with cerebral edema and could potentially be used as a biomarker for perioperative cerebral edema. This trial is registered with ChiCTR1900023742.

中文翻译：

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外周血 Occludin 水平作为脑肿瘤患者围手术期脑水肿的生物标志物。

目的脑水肿是脑肿瘤围手术期常见的并发症。然而，目前还没有可靠和方便的方法来评估脑水肿的程度。目的是探讨血清 occludin 对预测脑肿瘤患者围手术期脑水肿程度和预后的有效性。方法 这项前瞻性研究于 2019 年 6 月至 2019 年 11 月在三博脑科医院招募了 55 名脑肿瘤患者和 24 名健康对照。术前和术后第 1 天测量血清 occludin 水平。术前使用 MRI 评估瘤周水肿。使用 CT 评估术后第 1 天的腔周脑水肿。结果 与健康对照相比，脑肿瘤患者术前术后血清 occludin 水平均较高（P < 0.001）。血清 occludin 水平与术前（r = 0.78，P < 0.001）和术后（r = 0.59，P < 0.001）的脑水肿程度呈正相关。在 3.015 ng/mL 的最佳截止值下，术前血清 occludin 水平区分轻度和重度术前脑水肿的敏感性为 90.48%，特异性为 84.62%。在 3.033 ng/mL 的最佳截止值下，术后血清 occludin 水平区分轻度和重度术后脑水肿，敏感性为 97.30%，特异性为 55.56%。结论 血清 occludin 水平与脑水肿相关，可作为围手术期脑水肿的生物标志物。