Department of Neurosurgery, University Hospital of Essen, 45147, Essen, Germany.
German Cancer Consortium, Partner Site University Hospital Essen, Essen, Germany.
Mol Neurobiol. 2019 Sep;56(9):6071-6079. doi: 10.1007/s12035-019-1509-2. Epub 2019 Feb 4.
High-grade gliomas (HGG) are the most common malignant primary brain tumor in adults. During the course of disease, several challenges occur, like measuring tumor burden, monitoring of treatment response, estimating the patient's prognosis, and distinguishing between true progression and pseudo-progression. So far, no blood-based biomarker has been established in the clinical routine to address these challenges. The aim of this systematic review was to analyze the present evidence on blood-based biomarkers for HGG. We systematically searched in PubMed, Web of Sciences, Scopus, and Cochrane Library databases for publications before 30th of March 2018 reporting on associations of blood-based biomarkers in HGG patients with different endpoints as overall survival, progression-free survival, and postoperative monitoring. Quality assessment of the studies according to QUIPS and STARD guidelines was performed. In accordance with the GRADE guidelines, level of evidence (I-IV) for each of the tested biomarkers was assessed. One thousand six hundred eighty unique records were identified. Of these, 170 original articles were included to this review. Four hundred fifteen different blood-based biomarkers analyzed in 15.041 patients with HGG as also their corresponding recurrent tumors. Ten predictive biomarkers reached level II of evidence. No biomarker achieved level I of evidence. In this review, 10 blood-based biomarkers were selected as most promising biomarkers for HGG: α2-Heremans-Schmid glycoprotein (AHSG), albumin, glucose, insulin-like growth factor- binding protein 2 (IGFBP-2), macrophage inflammatory protein 1δ (MIP-1 δ), macrophage inflammatory protein 3ß (MIP-3ß), neutrophil-lymphocyte ratio (NLR), red blood cell distribution width (RDW), soluble glycoprotein 130 (Sgp130), and chitinase-3-like protein 1 (YKL-40). To further assess the clinical significance of these biomarkers, the evaluation in a larger cohort of HGG and their corresponding subgroups would be necessary.
高级别胶质瘤（HGG）是成人中最常见的恶性原发性脑肿瘤。在疾病过程中，会出现一些挑战，例如测量肿瘤负担、监测治疗反应、评估患者预后以及区分真性进展和假性进展。到目前为止，尚未在临床常规中建立基于血液的生物标志物来应对这些挑战。本系统综述的目的是分析目前关于 HGG 基于血液的生物标志物的证据。我们系统地在 PubMed、Web of Sciences、Scopus 和 Cochrane Library 数据库中搜索了截至 2018 年 3 月 30 日发表的关于 HGG 患者不同终点（总生存期、无进展生存期和术后监测）的血液生物标志物的关联的研究。根据 QUIPS 和 STARD 指南对研究进行了质量评估。根据 GRADE 指南，对每个测试的生物标志物的证据水平（I-IV）进行了评估。确定了 1680 条独特的记录。其中，纳入了 170 篇原始文章进行综述。在 15041 名 HGG 患者及其相应的复发性肿瘤中分析了 415 种不同的基于血液的生物标志物。10 种预测性生物标志物达到了 II 级证据水平。没有一种生物标志物达到了 I 级证据水平。在本综述中，选择了 10 种有希望的 HGG 基于血液的生物标志物：α2-赫曼斯-施密特糖蛋白（AHSG）、白蛋白、葡萄糖、胰岛素样生长因子结合蛋白 2（IGFBP-2）、巨噬细胞炎性蛋白 1δ（MIP-1δ）、巨噬细胞炎性蛋白 3β（MIP-3β）、中性粒细胞-淋巴细胞比值（NLR）、红细胞分布宽度（RDW）、可溶性糖蛋白 130（Sgp130）和几丁质酶 3 样蛋白 1（YKL-40）。为了进一步评估这些生物标志物的临床意义，需要在更大的 HGG 队列及其相应亚组中进行评估。
