• Jaime Gállego Pérez-Larraya, Sophie Paris, Ahmed Idbaih, Caroline Dehais, Florence Laigle-Donadey, Soledad Navarro, Laurent Capelle, Karima Mokhtari, Yannick Marie, Marc Sanson, Khê Hoang-Xuan, Jean-Yves Delattre, and Alain Mallet.
• Neurology Service 2, Mazarin Division, Pitié-Salpêtrière Hospital, AP-HP; Sorbonne Universités, UPMC Univ Paris 06, UM 75; CNRS, UMR 7225; Inserm, U1127; ICM, F-75013, Paris, France; Department of Neurology, Clinic of the University of Navarra, University of Navarra School of Medicine, Pamplona, Spain.
• Cancer. 2014 Dec 15;120(24):3972-80.

BackgroundCirculating proteins released by tumor cells have recently been investigated as potential single surrogate biomarkers for glioblastoma multiforme (GBM). The aim of the current hypothesis-generating study was to evaluate the diagnostic and prognostic role of preoperative insulin-like growth factor-binding protein 2 (IGFBP-2), chitinase-3-like protein 1 (YKL-40), and glial fibrillary acidic protein (GFAP) plasma levels in patients with GBM, both as single markers and as a combined profile.MethodsPlasma samples from 111 patients with GBM and a subset of 40 patients with nonglial brain tumors were obtained preoperatively. Plasma from 99 healthy controls was also analyzed. IGFBP-2, YKL-40, and GFAP levels were determined using enzyme-linked immunoadsorbent assay tests. Their association with histological and radiological variables was assessed.ResultsCirculating levels of all 3 proteins were found to be significantly higher in patients with GBM compared with healthy controls (P < .01). Only YKL-40 and GFAP were found to demonstrate significant differences between patients with GBM and nonglial brain tumors (P = .04). GFAP was undetectable (<0.02 ng/mL) in all patients without GBM. A receiver operating characteristic analysis accounting for a 2-step diagnostic procedure including the 3 biomarkers afforded an area under the curve of 0.77 for differentiating patients with GBM from those with nonglial brain tumors. There was a significant correlation between tumor volume and plasma IGFBP-2 level (Spearman Rho correlation coefficient, 0.22; P = .025) and GFAP (Spearman Rho correlation coefficient, 0.36; P < .001) among patients with GBM. Preoperative plasma IGFBP-2 levels were found to be independently associated with worse overall survival among patients with GBM (hazard ratio, 1.3; P = .05).ConclusionsA combined profile of preoperative IGFBP-2, GFAP, and YKL-40 plasma levels could serve as an additional diagnostic tool for patients with inoperable brain lesions suggestive of GBM. In addition, IGFBP-2 levels appear to constitute an independent prognostic factor in patients with GBM.© 2014 American Cancer Society.

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