Peter Baumgarten1, Johanna Quick-Weller2, Florian Gessler2, Marlies Wagner3, Julia Tichy4, Marie-Therese Forster2, Christian Foerch4, Volker Seifert2, Michel Mittelbronn5,6,7,8,9,10,11, Christian Senft2. 1. Department of Neurosurgery, University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany. peter.baumgarten2@kgu.de. 2. Department of Neurosurgery, University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany. 3. Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt am Main, Germany. 4. Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany. 5. Edinger Institute, Goethe University Frankfurt, Frankfurt am Main, Germany. 6. German Cancer Consortium (DKTK), Heidelberg, Germany. 7. German Cancer Research Center (DKFZ), Heidelberg, Germany. 8. Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg. 9. Laboratoire National de Santé (LNS), Dudelange, Luxembourg. 10. NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health (L.I.H.), Luxembourg, Luxembourg. 11. Luxembourg Centre of Neuropathology (LCNP), Dudelange, Luxembourg.
Abstract
SUBJECT: To date there is no established tumor marker for the clinical follow-up of glioblastoma, WHO grade IV, (GBM) which constitutes the most frequent and malignant primary brain tumor. However, since there is promising data that the serum glial fibrillary acidic protein (sGFAP) may serve as a biomarker for glial brain tumors, this prospective study aimed at evaluating the diagnostic relevance of perioperative changes in sGFAP levels for the assessment of residual glial tumor tissue in patients undergoing surgery of intracerebral tumors. METHODS: Serum GFAP was measured using an electrochemiluminometric immunoassay (ElecsysR GFAP prototype test, Roche Diagnostics, Penzberg/Germany) in 32 prospectively recruited patients between September 2009 and August 2010. Twenty-five were diagnosed with glioma and seven with brain metastases (BM). We assessed sGFAP levels prior to and at different time points during the early postoperative phase until patient discharge. RESULTS: There were only significant differences in the pre-operative sGFAP levels of patients with gliomas compared to BM (0.18 vs. 0.08 µg/l; p = 0.0198, Welch's t-Test). Even though there was an increase of sGFAP after surgery, there were no significant differences between glioma and BM patients at any other time point. Peak sGFAP levels where reached on postoperative day 1 followed by a slight decrease, but not reaching pre-operative levels until postop day 7. There was no significant correlation between postoperative glioma tumor volume and sGFAP levels in univariate analyses. CONCLUSION: According to our data sGFAP does not appear to be suitable to detect residual glioma tissue in the acute postoperative phase.
SUBJECT: To date there is no established tumor marker for the clinical follow-up of glioblastoma, WHO grade IV, (GBM) which constitutes the most frequent and malignant primary brain tumor. However, since there is promising data that the serum glial fibrillary acidic protein (sGFAP) may serve as a biomarker for glial brain tumors, this prospective study aimed at evaluating the diagnostic relevance of perioperative changes in sGFAP levels for the assessment of residual glial tumor tissue in patients undergoing surgery of intracerebral tumors. METHODS: Serum GFAP was measured using an electrochemiluminometric immunoassay (ElecsysR GFAP prototype test, Roche Diagnostics, Penzberg/Germany) in 32 prospectively recruited patients between September 2009 and August 2010. Twenty-five were diagnosed with glioma and seven with brain metastases (BM). We assessed sGFAP levels prior to and at different time points during the early postoperative phase until patient discharge. RESULTS: There were only significant differences in the pre-operative sGFAP levels of patients with gliomas compared to BM (0.18 vs. 0.08 µg/l; p = 0.0198, Welch's t-Test). Even though there was an increase of sGFAP after surgery, there were no significant differences between glioma and BM patients at any other time point. Peak sGFAP levels where reached on postoperative day 1 followed by a slight decrease, but not reaching pre-operative levels until postop day 7. There was no significant correlation between postoperative glioma tumor volume and sGFAP levels in univariate analyses. CONCLUSION: According to our data sGFAP does not appear to be suitable to detect residual glioma tissue in the acute postoperative phase.
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