Serum lactate levels are associated with glioma malignancy grade

Clin Neurol Neurosurg. 2019 Nov:186:105546. doi: 10.1016/j.clineuro.2019.105546. Epub 2019 Oct 1.

Abstract

Objective: Recent studies have suggested that high grade gliomas are associated with elevated serum lactate concentrations. The aim of the present study is to assess these findings in a sample of patients.

Patients and methods: We reviewed the anesthetic charts of patients with low-grade and high-grade glioma who underwent resection surgery and collected serum lactate concentration before tumor resection, as well as other demographic and tumor-related data (age, gender, WHO grade, and size of the tumor). A statistical comparison between patients with normal (<2 mmol/L) and elevated (≥ 2 mmol/L) serum lactate was performed.

Results: We included a total of 152 patients (mean age 49.07 years). 62.5% of patients (n = 95) had a high-grade glioma and 37.5% (n = 67) a low-grade glioma. The multivariate regression showed that high grade gliomas had significantly higher lactate concentration (p < 0.01). The OR for elevated pre-resection serum lactate increased from 4.94 to 14.33 after adjusting for age and pre-surgical corticosteroid use, and the AUC for the final regression model was 0.98.

Conclusion: This study reinforces the role of serum lactate as a potential biomarker of brain tumors malignancy, and its results encourage further research on this subject, in order to improve the understanding of this phenomenon and to assess its potential as prognostic and therapeutic monitoring tool.

Keywords: Biomarker; Diagnosis; Glioma; Lactate; Neuro-oncology; Neurosurgery.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood*
  • Brain Neoplasms / blood*
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / surgery
  • Glioma / blood*
  • Glioma / diagnosis*
  • Glioma / surgery
  • Humans
  • Lactic Acid / blood*
  • Male
  • Middle Aged
  • Neoplasm Grading / methods

Substances

  • Biomarkers, Tumor
  • Lactic Acid