The prognostic value of tumor markers in patients with glioblastoma multiforme: analysis of 32 patients and review of the literature

J Neurooncol. 2001 Dec;55(3):195-204. doi: 10.1023/a:1013845004294.

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / analysis
  • Adult
  • Aged
  • Aged, 80 and over
  • Aneuploidy
  • Biomarkers, Tumor / analysis*
  • Brain Neoplasms / chemistry*
  • Brain Neoplasms / mortality
  • Cohort Studies
  • DNA, Neoplasm / analysis
  • Female
  • Glioblastoma / chemistry*
  • Glioblastoma / mortality
  • Glutathione S-Transferase pi
  • Glutathione Transferase / analysis
  • Humans
  • Isoenzymes / analysis
  • Ki-67 Antigen / analysis
  • Life Tables
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Proteins / analysis*
  • Nerve Tissue Proteins / analysis*
  • Prognosis
  • S Phase
  • Survival Analysis
  • Tumor Suppressor Protein p53 / analysis

Substances

  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Isoenzymes
  • Ki-67 Antigen
  • Neoplasm Proteins
  • Nerve Tissue Proteins
  • Tumor Suppressor Protein p53
  • GSTP1 protein, human
  • Glutathione S-Transferase pi
  • Glutathione Transferase