Plasma IGFBP-2 Levels Predict Clinical Outcomes of Patients With High-Grade Gliomas

Neuro Oncol. 2009 Oct;11(5):468-76. doi: 10.1215/15228517-2008-114. Epub 2009 Jan 22.

Abstract

Insulin-like growth factor binding protein 2 (IGFBP-2) is a malignancy-associated protein measurable in tumors and blood. Increased IGFBP-2 is associated with shortened survival of advanced glioma patients. Thus, we examined plasma IGFBP-2 levels in glioma patients and healthy controls to evaluate its value as a plasma biomarker for glioma. Plasma IGFBP-2 levels in 196 patients with newly diagnosed glioma and 55 healthy controls were analyzed using an IGFBP-2 ELISA kit. Blood was collected before surgery, after two-cycle adjuvant chemotherapy, and at recurrence. Plasma IGFBP-2 levels were correlated with disease-free survival (DFS) using Cox regression analyses. We found that preoperative plasma IGFBP-2 levels were significantly higher in high-grade glioma patients (n = 43 for grade III glioma; n = 72 for glioblastoma multiforme [GBM]) than in healthy controls (n = 55; p < 0.001) and low-grade (grade II) glioma patients (n = 81; p < 0.001). No significant differences in preoperative plasma IGFBP-2 levels were observed between grade III glioma and GBM patients or between grade II glioma patients and healthy controls. After recurrence, plasma IGFBP-2 levels were significantly increased in GBM patients (n = 26; p < 0.001). Preoperative plasma IGFBP-2 levels were significantly correlated with DFS in GBM patients (hazard ratio, 1.404; 95% confidence interval, 1.078-1.828; p = 0.012). We conclude that preoperative plasma IGFBP-2 levels are significantly higher in high-grade glioma patients than in low-grade glioma patients and healthy subjects, and are significantly correlated with recurrence and DFS in patients with GBM. Longitudinal studies with a larger study population are needed to confirm these findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / blood*
  • Brain Neoplasms / blood*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Disease-Free Survival
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Glioma / blood*
  • Glioma / pathology
  • Glioma / therapy
  • Humans
  • Immunohistochemistry
  • Insulin-Like Growth Factor Binding Protein 2 / blood*
  • Kaplan-Meier Estimate
  • Male
  • Neoplasm Recurrence, Local / blood
  • Neurosurgical Procedures
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Insulin-Like Growth Factor Binding Protein 2