• Satoru Takeuchi, Kojiro Wada, Terushige Toyooka, Nariyoshi Shinomiya, Hideyuki Shimazaki, Kuniaki Nakanishi, Kimihiro Nagatani, Naoki Otani, Hideo Osada, Yoichi Uozumi, Hirotaka Matsuo, and Hiroshi Nawashiro.
• Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan. s.takeuchi@room.ocn.ne.jp
• Neurosurgery. 2013 Jan 1; 72 (1): 33-41; discussion 41.

BackgroundxCT is a light chain of the cystine/glutamate antiporter system xc. Glutamate that is released by system xc plays an important role in the infiltration of glioblastoma (GBM) cells. Furthermore, increased glutathione synthesis by system xc may protect tumor cells against oxidative stress induced by radiotherapy and chemotherapy.ObjectiveTo investigate whether the levels of xCT expression correlated with infiltrative imaging phenotypes on magnetic resonance imaging and outcomes in patients with GBMs.MethodsForty patients with histologically confirmed primary GBMs were included in the study. Patient charts were retrospectively reviewed for age, sex, Karnofsky Performance Status Scale score, Mini-Mental State Examination score, magnetic resonance imaging features, xCT expression, isocitrate dehydrogenase 1 R132H expression, O-methylguanine-DNA methyltransferase promoter methylation status, type of surgery, progression-free survival, and overall survival.ResultsIn invasive margins, xCT expression was weak in 20 patients and strong in 20 patients. A Cox regression model revealed that a Karnofsky Performance Status Scale score less than 60 (hazard ratio [HR]: 4.525; P = .01), partial removal (HR: 2.839; P = .03), and strong xCT expression (HR: 4.134; P < .001) were significantly associated with shorter progression-free survival and that partial removal (HR: 2.865; P = .03), weak isocitrate dehydrogenase 1 R132H expression (HR: 15.729; P = .01), and strong xCT expression (HR: 2.863; P = .04) were significantly associated with shorter overall survival.ConclusionThese findings suggest that xCT is an independent predictive factor in GBMs.

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