Abstract
IntroductionMalignant primary brain tumors are one of the most aggressive cancers. Pretreatment serum nonneuronal biomarkers closely associated with postoperative outcomes are of high clinical relevance. The present study aimed to identify potential pretreatment serum biomarkers that may influence oncological outcomes in patients with primary brain tumors.MethodsA total of 74 patients undergoing supratentorial primary brain tumor resection were enrolled. Before tumor resection, serum neuronal biomarkers, namely neuron-specific enolase (NSE), S100β, and glial fibrillary acidic protein (GFAP), and serum nonneuronal biomarkers, namely neutrophil gelatinase-associated lipocalin (NGAL), lactate dehydrogenase (LDH), and lactate, were measured and associated postoperative oncological outcomes, including brain tumor grading, progression-free survival (PFS), and overall survival (OS), were compared.ResultsPatients with high-grade brain tumors had significantly higher pretreatment serum lactate levels (p = 0.011). By contrast, other biomarkers were comparable between patients with high-grade and low-grade brain tumors. Receiver operating characteristic curve analysis of serum lactate levels yielded an area under the curve of 0.71 for differentiating between high-grade and low-grade brain tumors. Kaplan–Meier survival analysis revealed patients with high serum lactate levels (≧2.0 mmol/L) had shorter PFS and OS (p = 0.021 and p = 0.093, respectively). In a multiple regression model, only elevated serum lactate levels were associated with poor PFS and OS (p = 0.021 and p = 0.048, respectively).ConclusionsAn elevated pretreatment serum lactate level is a prognostic biomarker of high-grade primary brain tumors and is significantly associated with poor PFS in patients with supratentorial brain tumors undergoing tumor resection. By contrast, other serum biomarkers are not significantly associated with oncological outcomes.
Highlights
Malignant primary brain tumors are one of the most aggressive cancers
Receiver operating characteristic curve analysis of serum lactate levels yielded an area under the curve of 0.71 for differentiating between high-grade and low-grade brain tumors
An elevated pretreatment serum lactate level is a prognostic biomarker of high-grade primary brain tumors and is significantly associated with poor progression-free survival (PFS) in patients with supratentorial brain tumors undergoing tumor resection
Summary
Malignant primary brain tumors are one of the most aggressive cancers. Pretreatment serum nonneuronal biomarkers closely associated with postoperative outcomes are of high clinical relevance. Elevated levels of several www.impactjournals.com/oncotarget serum biomarkers, including neuronal and nonneuronal biomarkers, have been reported in patients with brain tumors. The association between serum neuronal biomarkers and oncological outcomes after tumor resection has yet to be sufficiently investigated in patients with brain tumors. Elevated levels of nonneuronal biomarkers, including tissue and urinary neutrophil gelatinaseassociated lipocalin (NGAL) and tissue lactate, have been reported in patients with brain tumors. Higher tissue and urinary NGAL levels have been reported in patients with brain tumors [5, 6]. As a bridge between tissue and urinary biomarkers, serum NGAL levels have been investigated insufficiently in patients with brain tumors
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