Identification of perioperative neurocognitive dysfunction biomarkers in cerebrospinal fluid with quantitative proteomic approach in patients undergoing transurethral resection of prostate with combined spinal and epidural analgesia.

Abstract

This study aimed to identify predictive biomarkers of perioperative neurocognitive dysfunction (PND) in cerebrospinal fluid of elderly male patients undergoing elective transurethral resection of prostate, using an isobaric tags for relative and absolute quantitative-based quantitative proteomic approach. Patients were evaluated with Mini Mental State Examination at -1 and+3 days of operation. Presence of PND was determined with Z-score method. Patients characteristics and quantitative cerebrospinal fluid proteomes detected with isobaric tags for relative and absolute quantitative-were compared between PND and non-PND patients. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis were performed to identify pathways potentially involved in PND. A total of 229 patients were included in the study and 32 were diagnosed with PND (incidence 14.4%). The age, incidence of hypertension, and diabetes of PND patients were significantly higher than non-PND patients (P < .05). There were 85 differentially expressed proteins identified, among which High Mobility Group Box 1, prostaglandin D synthase, and matrix metalloproteinase inhibitor were considered to be promising candidates as they might play important roles in pathophysiology of PND. Proteomic approach identified potential biomarkers for predicting the occurrence of PND. These findings need to be validated in further studies.