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Abstract
Introduction. Glioblastoma is the most malignant primary brain tumor. Progression and relapse of this neoplasm remain inevitable. Cancer stem cells (CSCs) are thought to contribute to treatment resistance in glioblastoma. Currently, there is no ideal set of markers to accurately characterize CSCs to predict the course of the disease or response to treatment.
Aim. To study the long-term results of treatment of patients with glioblastomas based on the analysis of the presence and degree of expression of CSC markers.
Materials and methods. Total microsurgical tumor removal was performed in 16 patients with verified Grade 4 glioblastoma (IDH-wildtype). Follow-up observation was carried out from March 2019 to October 2023. The average overall survival (OS) was 17.0 ± 10.7 months (Q1-11.3, Q3-22.8), minimum — 4.1 months, maximum — 36.8 months. A correlation analysis of the relationship between OS and glioblastoma cancer stem cell markers such as Nanog, Nestin, CD133, SOX2, FOXM1 and CD38 %, was performed. Statistical analysis was carried out using StatTech v. 3.1.10 (developer — StatTech LLC, Russia).
Results. According to the results of correlation analysis, there was no association association between Nanog expression and OS. A weak inverse relationship was found between nestin, CD133 %, CD38 % and OS. A weak direct relationship was established between SOX2 and OS. A moderately strong direct relationship was established between FOXM1 and OS. We assessed the dependence of OS on a set of CSC markers using the multiple linear regression method. The resulting regression model is characterized by a correlation coefficient rxy = 0.534, which corresponds to an average regression coefficient on the Chaddock scale. The model was not statistically significant (p = 0.725). Thus, the cancer stem cell markers we studied are not predictors for the OS prediction model; statistically significant relationships were not found.
Conclusion. The study of glioblastoma markers in CSCs to predict treatment outcome is currently impractical and has no impact on treatment. Today, the main proven approach to treating patients with glioblastoma is local tumor control.
References
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