Cerebrospinal fluid cellular and inflammatory profiles in tumor-related postoperative infections: influencing factors and clinical features in oncological patients.

Cancer patients undergoing craniocerebral surgery are at risk of secondary intracranial infection, yet differentiating postoperative infection from sterile inflammatory response remains challenging. This study investigated the cerebrospinal fluid (CSF) cellular and inflammatory characteristics, influencing factors, and clinical features of tumor-related postoperative infections. This retrospective study analyzed 170 oncological patients after cranial surgery (36 with intracranial infection, 134 with aseptic inflammation). CSF and blood samples were collected on postoperative days 1-3, 4-5, and 6-7. Assessments included CSF cytology, biochemistry (protein, glucose, chloride), serum markers (white blood cell [WBC] count, C-reactive protein [CRP], procalcitonin [PCT]), CSF culture, and endotoxin detection. Multivariate logistic regression identified risk factors for infection. The infection group showed persistently higher CSF WBC count, neutrophil percentages, and protein levels, and lower glucose levels across all three time points (all P < 0.01). Serum CRP and PCT were significantly elevated in the mid-to-late postoperative period (both P < 0.05). Independent risk factors included surgery duration > 4 hours (aOR = 3.35, 95% CI 1.39-8.09), external ventricular drainage (EVD) placement (aOR = 2.86, 95% CI 1.21-6.77), and EVD indwelling time > 7 days (aOR = 3.74, 95% CI 1.49-9.41). Patients with ventriculitis had worse prognosis and higher hydrocephalus incidence than those with meningitis alone (both P < 0.05). Postoperative intracranial infection in neurotumor patients induces characteristic dynamic changes in CSF and serum inflammatory markers. Regular monitoring facilitates early differentiation from aseptic inflammation, and ventriculitis predicts poorer clinical outcome.