Tichy Julia, Spechtmeyer Sabrina, Mittelbronn Michel, Hattingen Elke, Rieger Johannes, Senft Christian, Foerch Christian
Department of Neurology, Goethe-University, Frankfurt am Main, Germany.
Dr. Senckenberg Institute of Neurooncology, Goethe-University, Frankfurt am Main, Germany.
J Neurooncol. 2016 Jan;126(2):361-9. doi: 10.1007/s11060-015-1978-8. Epub 2015 Oct 30.
Glioblastoma (GBM) is the most common malignant primary brain tumor. Although clinical presentation and brain imaging might be suggestive, histopathological evaluation by means of a brain biopsy is routinely performed to establish the diagnosis. A serum marker indicative of GBM may simplify the diagnostic work-up of patients suspected to having a brain tumor. We prospectively examined 113 patients with newly diagnosed single supratentorial or infratentorial space-occupying brain lesions. Glial fibrillary acidic protein (GFAP) levels were determined from venous blood samples via a prototype ELISA assay prior to any invasive procedures. Serum levels of GFAP were correlated with histopathological findings and MRI parameters. GFAP values were significantly higher in GBM patients (n = 33) compared to all other tumors (p < 0.001). A GFAP serum concentration of ≥0.01 µg/L revealed a sensitivity of 85 % and a specificity of 70 % for differentiating GBM from other entities. By applying a GFAP cut-off point of 0.20 µg/L, specificity was maximized (99 %), but sensitivity dropped to 27 %. In GBM patients, serum GFAP values were significantly correlated with tumor volume. GBM patients with high GFAP levels showed more in vivo GFAP expression as well as more necrosis and perilesional edema compared to GBM patients having low or non-detectable GFAP levels. GFAP serum concentrations differentiated between patients with GBM and patients with cerebral mass lesions of other entities with a moderate diagnostic accuracy. Serum GFAP levels in GBM patients were positively correlated with tumor volume and histopathological tumor characteristics.
胶质母细胞瘤（GBM）是最常见的原发性恶性脑肿瘤。尽管临床表现和脑部影像学检查可能具有提示作用，但仍需常规进行脑活检的组织病理学评估以确诊。一种指示GBM的血清标志物可能会简化疑似脑肿瘤患者的诊断检查。我们前瞻性地研究了113例新诊断为幕上或幕下单一占位性脑病变的患者。在进行任何侵入性操作之前，通过原型酶联免疫吸附测定法从静脉血样本中测定胶质纤维酸性蛋白（GFAP）水平。GFAP的血清水平与组织病理学结果和MRI参数相关。与所有其他肿瘤相比，GBM患者（n = 33）的GFAP值显著更高（p < 0.001）。GFAP血清浓度≥0.01 µg/L时，鉴别GBM与其他实体的敏感性为85%，特异性为70%。应用GFAP临界值0.20 µg/L时，特异性最大化（99%），但敏感性降至27%。在GBM患者中，血清GFAP值与肿瘤体积显著相关。与GFAP水平低或检测不到的GBM患者相比，GFAP水平高的GBM患者体内GFAP表达更多，坏死和瘤周水肿也更多。GFAP血清浓度在鉴别GBM患者和其他实体脑占位性病变患者方面具有中等诊断准确性。GBM患者的血清GFAP水平与肿瘤体积和组织病理学肿瘤特征呈正相关。
