Cata J P, Bhavsar S, Hagan K B, Arunkumar R, Grasu R, Dang A, Carlson R, Arnold B, Popat K, Rao Ganesh, Potylchansky Y, Lipski I, Ratty Sally, Nguyen A T, McHugh Thomas, Feng L, Rahlfs T F
Department of Anesthesiology and Perioperative Medicine, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA.
Department of Anesthesiology and Perioperative Medicine, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA.
J Clin Neurosci. 2017 Sep;43:224-228. doi: 10.1016/j.jocn.2017.05.004. Epub 2017 Jun 7.
Cancer cells can produce lactate in high concentrations. Two previous studies examined the clinical relevance of serum lactate as a biomarker in patients with brain tumors. Patients with high-grade tumors have higher serum concentrations of lactate than those with low-grade tumors. We hypothesized that serum lactic could be used of biomarker to predictor of survival in patients with glioblastoma (GB).
This was a retrospective study. Demographic, lactate concentrations and imaging data from 275 adult patients with primary GB was included in the analysis. The progression free survival (PFS) and overall survival (OS) rates were compared in patients who had above and below the median concentrations of lactate. We also investigated the correlation between lactate concentrations and tumor volume. Multivariate analyses were conducted to test the association lactate, tumor volume and demographic variables with PFS and OS.
The median serum concentration of lactate was 2.3mmol/L. A weak correlation was found between lactate concentrations and tumor volume. Kaplan-Meier curves demonstrated similar survival in patients with higher or lower than 2.3mmol/L of lactate. The multivariate analysis indicated that the intraoperative levels of lactate were not independently associated with changes in survival. On another hand, a preoperative T1 volume was an independent predictor PFS (HR 95%CI: 1.41, 1.02-1.82, p=0.006) and OS (HR 95%CI: 1.47, 1.11-1.96, p=0.006).
This retrospective study suggests that the serum concentrations of lactate cannot be used as a biomarker to predict survival after GB surgery. To date, there are no clinically available serum biomarkers to determine prognosis in patients with high-grade gliomas. These tumors may produce high levels of lactic acid. We hypothesized that serum lactic could be used of biomarker to predictor of survival in patients with glioblastoma (GB). In this study, we collected perioperative and survival data from 275 adult patients with primary high-grade gliomas to determine whether intraoperative serum acid lactic concentrations can serve as a marker of prognosis. The median serum concentration of lactate was 2.3mmol/L. Our analysis indicated the intraoperative levels of lactate were not independently associated with changes in survival. This retrospective study suggests that the serum concentrations of lactate cannot be used as a biomarker to predict survival after GB surgery.
癌细胞可产生高浓度乳酸。此前两项研究探讨了血清乳酸作为脑肿瘤患者生物标志物的临床相关性。高级别肿瘤患者的血清乳酸浓度高于低级别肿瘤患者。我们假设血清乳酸可作为胶质母细胞瘤（GB）患者生存预测的生物标志物。
这是一项回顾性研究。分析纳入了275例成年原发性GB患者的人口统计学、乳酸浓度和影像学数据。比较乳酸浓度高于和低于中位数的患者的无进展生存期（PFS）和总生存期（OS）率。我们还研究了乳酸浓度与肿瘤体积之间的相关性。进行多变量分析以检验乳酸、肿瘤体积和人口统计学变量与PFS和OS的关联。
血清乳酸的中位数浓度为2.3mmol/L。发现乳酸浓度与肿瘤体积之间存在弱相关性。Kaplan-Meier曲线显示，乳酸浓度高于或低于2.3mmol/L的患者生存期相似。多变量分析表明，术中乳酸水平与生存变化无独立相关性。另一方面，术前T1体积是PFS（风险比95%置信区间：1.41，1.02 - 1.82，p = 0.006）和OS（风险比95%置信区间：1.47，1.11 - 1.96，p = 0.006）的独立预测因素。
这项回顾性研究表明，血清乳酸浓度不能用作预测GB手术后生存的生物标志物。迄今为止，尚无临床上可用于确定高级别胶质瘤患者预后的血清生物标志物。这些肿瘤可能产生高水平的乳酸。我们假设血清乳酸可作为胶质母细胞瘤（GB）患者生存预测的生物标志物。在本研究中，我们收集了275例成年原发性高级别胶质瘤患者的围手术期和生存数据，以确定术中血清乳酸浓度是否可作为预后标志物。血清乳酸的中位数浓度为2.3mmol/L。我们的分析表明，术中乳酸水平与生存变化无独立相关性。这项回顾性研究表明，血清乳酸浓度不能用作预测GB手术后生存的生物标志物。
