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Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 32-37

Interlinked expression of tumor attributes: Can their evaluation serve as a noninvasive paradigm for prognosis in glioblastoma?

1 Department of Research, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
2 Department of Neurosurgery, Bhopal Memorial Hospital and Research Centre, Bansal Hospital, Bhopal, Madhya Pradesh, India
3 Department of Neurosurgery, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India

Correspondence Address:
Dr. Puneet Gandhi
Department of Research, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJNO.IJNO_22_19

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Background: Glioblastoma (GB) is one of the deadliest brain cancers with a bleak prognosis. It is characterized by highly proliferating tumor cells influenced by surrounding stroma, with a constant detectable communication between the tumor and its environmental components, which can be assessed in terms of specific proteins. Patients and Methods: To experimentally establish this cellular dialog, we undertook to evaluate plasma expression of three proteins: human telomerase reverse transcriptase (hTERT), chitinase-like protein (YKL-40), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in 66 individuals inclusive of thirty primary and two secondary GB patients and 34 age-matched controls, with reference to proliferation, angiogenesis, and extracellular matrix (ECM) degradation biomarkers. A follow-up at 3 months postsurgery for marker profile was done for GB. Results: Plasma levels of markers were higher in therapy-naive patients than in controls (P < 0.0001). In a 3-month follow-up, these levels were found to be higher in patients who survived for ≤4 months than nine patients who had lower values with better survival. A strong correlation existed between hTERT, YKL-40, and TIMP-1 levels; Cox regression analysis revealed higher levels of these circulating markers as poor prognostic indicators. The sensitivity of these markers increased to 96.9% in combination, thereby improving the accuracy of prognosis. Confounders, i.e. age, site, and extent of resection, had no effect on the prognostication of these markers. Conclusion: These experimental blood-based data define the influence of angiogenesis and ECM remodeling on proliferation of GB relative to poor survival, using a panel of biomarkers. Evaluating the disease outcome noninvasively can pave the way for designing intervention strategy to control angiogenesis and ECM degradation and in turn tumor progression.

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