Expression Levels of t-PA，TN-C and Cav-1 in Patients with Different Clinical Outcomes after Decompressive Craniectomy for Massive Cerebral Infarction

Dongliang GUO; Dehui LI; Na WANG

doi:10.12259/j.issn.2095-610X.S20260314

Volume 47 Issue 3

Mar. 2026

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Dongliang GUO, Dehui LI, Na WANG. Expression Levels of t-PA，TN-C and Cav-1 in Patients with Different Clinical Outcomes after Decompressive Craniectomy for Massive Cerebral Infarction[J]. Journal of Kunming Medical University, 2026, 47(3): 123-132. doi: 10.12259/j.issn.2095-610X.S20260314

Citation:

Dongliang GUO, Dehui LI, Na WANG. Expression Levels of t-PA，TN-C and Cav-1 in Patients with Different Clinical Outcomes after Decompressive Craniectomy for Massive Cerebral Infarction[J]. Journal of Kunming Medical University, 2026, 47(3): 123-132. doi: 10.12259/j.issn.2095-610X.S20260314

Citation:

Dongliang GUO, Dehui LI, Na WANG. Expression Levels of t-PA，TN-C and Cav-1 in Patients with Different Clinical Outcomes after Decompressive Craniectomy for Massive Cerebral Infarction[J]. Journal of Kunming Medical University, 2026, 47(3): 123-132. doi: 10.12259/j.issn.2095-610X.S20260314

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Expression Levels of t-PA，TN-C and Cav-1 in Patients with Different Clinical Outcomes after Decompressive Craniectomy for Massive Cerebral Infarction

doi: 10.12259/j.issn.2095-610X.S20260314

1.
Department of Neurocritical Care Medicine，Beijing Chaoyang Integrated Traditional Chinese and Western Medicine Emergency Rescue Hospital，Beijing 100101
2.
Department of Surgery，Shishi Hospital，Tianjin 300000，China

Received Date: 2025-11-26
Available Online: 2026-03-09
Publish Date: 2026-03-31

Abstract

Abstract

Objective To analyze the expression levels of tissue-type plasminogen activator （t-PA）, tenascin C （TN-C） and caveolin-1 （Cav-1） in patients with different clinical outcomes after decompressive craniectomy for massive cerebral infarction. Methods A total of 184 patients scheduled for decompressive craniectomy due to massive cerebral infarction at Beijing Chaoyang Emergency Medical Center for Integrated Traditional Chinese and Western Medicine from January 2021 to October 2024 were selected as the research objects. According to the outcomes of the disease 3 months after operation, they were divided into a poor outcome group （n = 58） and a good outcome group （n = 126）. Baseline data [glasgow coma scale （GCS）, national Institute of Health stroke scale （NIHSS）score, etc.], the levels of t-PA, TN-C and Cav-1 at 24 h and 3 d after operation and their change values were compared between the two groups. Multivariate Logistic regression equation was used to analyze the effect of perioperative changes in t-PA, TN-C and Cav-1 on the outcome of the disease. Receiver operating characteristic curve （ROC） was used to analyze the value of perioperative changes of t-PA, TN-C and Cav-1 in predicting the outcome of the disease. Results The preoperative GCS score of the poor group was lower than that of the good group, and the preoperative NIHSS score was higher than that of the good group （P < 0.05）. The △t-PA, △TN-C and △Cav-1 values 24 hours and 3 days postoperatively were lower in the poor outcome group than those in the good group （all P < 0.05）. Multivariate analysis showed that after adjusting for GCS score and NIHSS score, the △t-PA, △TN-C and △Cav-1 values 24 hours and 3 days operation were still related factors affecting the outcome of large area cerebral infarction after decompressive craniectomy （ all P < 0.05）. ROC analysis demonstrated that the area under the curve （AUC） for predicting outcome was greater for the biomarker changes measured at 3 days postoperatively compared to those at 24 hours, indicating higher predictive value. Specifically, the combined AUC for ∆t-PA + ∆TN-C + ∆Cav-1 at 3 days postoperatively was 0.960, which was significantly higher than the combined AUC for the 24-hour measurements （Z = 2.735, P = 0.044）, showing superior value in predicting poor clinical outcomes with a sensitivity of 91.38% and a specificity of 90.48%. Conclusion The expression levels of t-PA, TN-C and Cav-1 in patients with different disease outcomes after decompressive craniectomy for massive cerebral infarction are significantly different. Combined detection of the changes in these three biomarkers, particularly at 3 days after operation has a higher predictive value for clinical outcome.
- Tissue-type plasminogen activator,
- Tenascin C,
- Caveolin-1,
- Massive cerebral infarction,
- Decompressive craniectomy,
- Clinical outcome,
- Relevance,
- Predictive efficacy

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