title: The prognostic value of tumor markers in patients with glioblastoma multiforme: analysis of 32 patients and review of the literature.
abstract: Although several studies have examined brain tumor markers for prognostic value, few investigations have stratified analysis based on specific histologic grade. The objective of this study was to evaluate a single histologic grade of glioma, the grade IV glioma or glioblastoma (World Health Organization Classification), with a comprehensive panel of tumor markers in an attempt to identify those with prognostic significance. Tumor samples from a cohort of patients with glioblastoma multiforme (n = 32) were examined for tumor markers, DNA analysis, and clinical variables in an attempt to determine a 'profile' for this tumor. We used univariate and multivariate statistical analysis to determine the prognostic value of tumor cell ploidy, percent S-phase, DNA index, p53, and Ki-67 labeling index, as well as the variables of gender, race, age, location of tumor, history of chemotherapy, and primary versus recurrent tumor. Two additional tumor markers, multidrug resistance gene 1 and glutathione-S-transferase subtype pi, were included in the sample testing, but were not analyzed statistically. Univariate analysis indicated that increasing age had a strong association with decreased survival. Female gender, increasing Ki-67, no chemotherapy before sample collection, and primary glioblastoma showed some association with decreased survival in the univariate model. The univariate results indicated that race, side of tumor, ploidy, S-phase, DNA index, and p53 had no prognostic value. Multivariate modeling demonstrated that age, gender, and Ki-67 were the strongest factors associated with survival. The relevant literature is reviewed.
authors.affiliation: Hunterian Neurosurgical Laboratory, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Reavey-Cantwell
authors.forename: R I
authors.initials: RI
authors.lastname: Haroun
authors.forename: M
authors.initials: M
authors.lastname: Zahurak
authors.forename: R E
authors.initials: RE
authors.lastname: Clatterbuck
authors.forename: R J
authors.initials: RJ
authors.lastname: Parker
authors.forename: R
authors.initials: R
authors.lastname: Mehta
authors.forename: J P
authors.initials: JP
authors.lastname: Fruehauf
authors.forename: H
authors.initials: H
authors.lastname: Brem
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000032:analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D014408:Biomarkers, Tumor / Q000032:analysis*; D001932:Brain Neoplasms / Q000737:chemistry* / Q000401:mortality; D015331:Cohort Studies; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005909:Glioblastoma / Q000737:chemistry* / Q000401:mortality; D051549:Glutathione S-Transferase pi; D005982:Glutathione Transferase / Q000032:analysis; D006801:Humans; D007527:Isoenzymes / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000032:analysis*; D009419:Nerve Tissue Proteins / Q000032:analysis*; D011379:Prognosis; D016196:S Phase; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D007527:Isoenzymes; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009419:Nerve Tissue Proteins; D016159:Tumor Suppressor Protein p53; C496556:GSTP1 protein, human; D051549:Glutathione S-Transferase pi; D005982:Glutathione Transferase