title: Serum lactate as a potential biomarker of malignancy in primary adult brain tumours.
abstract: Lactate, a by-product of glycolysis, is an indicator of poor tissue perfusion and is a useful biomarker with prognostic value in risk-stratifying patients in several diseases. Furthermore, elevated lactate production is observed in tumour glycolysis, also known as the Warburg effect, and is essential in promoting tumour cell invasion, metastasis, and immune system evasion, promoting resistance to cell death. However, there are no studies of elevated serum lactate in brain tumour patients as a potential biomarker, to our knowledge. The aim of this study is to determine possible correlations between the malignancy of tumours and pre- and intraoperative serum lactate elevation in patients undergoing craniotomy for tumour resection. We provide initial evidence that a rise in serum lactate can be used as a non-invasive biomarker that correlates with brain tumour grade. The results from this study and future prospective studies may allow for determination of tumour progression and response to therapy using serum lactate as a biomarker.
authors.affiliation: Department of Anesthesia, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Ramamani
authors.initials: R
authors.lastname: Mariappan
authors.affiliation: Department of Anesthesia, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Lashmi
authors.initials: L
authors.lastname: Venkatraghavan
authors.affiliation: Division of Neurosurgery, Department of Surgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-439, M5T 2S8 Toronto, Ontario, Canada.
authors.forename: Alenoush
authors.initials: A
authors.lastname: Vertanian
authors.affiliation: Division of Neurosurgery, Department of Surgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-439, M5T 2S8 Toronto, Ontario, Canada.
authors.forename: Sameer
authors.initials: S
authors.lastname: Agnihotri
authors.affiliation: Department of Anesthesia, Christian Medical College Hospital, Vellore, India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Cynthia
authors.affiliation: Division of Neurosurgery, Department of Surgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-439, M5T 2S8 Toronto, Ontario, Canada.
authors.forename: Sareh
authors.initials: S
authors.lastname: Reyhani
authors.affiliation: Division of Neurosurgery, Department of Surgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-439, M5T 2S8 Toronto, Ontario, Canada.
authors.forename: Takyee
authors.initials: T
authors.lastname: Tung
authors.affiliation: Division of Neurosurgery, Department of Surgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-439, M5T 2S8 Toronto, Ontario, Canada.
authors.forename: Osaama H
authors.initials: OH
authors.lastname: Khan
authors.affiliation: Division of Neurosurgery, Department of Surgery, University Health Network, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-439, M5T 2S8 Toronto, Ontario, Canada. Electronic address: gelareh.zadeh@uhn.ca.
authors.forename: Gelareh
authors.initials: G
authors.lastname: Zadeh
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001932:Brain Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D003399:Craniotomy; D018450:Disease Progression; D005260:Female; D006019:Glycolysis; D006801:Humans; D007432:Intraoperative Period; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D019344:Lactic Acid
keywords: Biomarker; Glioblastoma multiforme; Lactate; Serum; Tumour glycolysis; Warburg effect