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. 2013 Oct 8:11:264.
doi: 10.1186/1477-7819-11-264.

BMP4, a new prognostic factor for glioma

Qiang Wu  1 , Jiarui Yao
Affiliations

BMP4, a new prognostic factor for glioma

Qiang Wu et al. World J Surg Oncol. .

Abstract

Background: The expression status of bone morphogenetic protein 4 (BMP4) in gliomas is still unclear by now. We try to investigate the relationship between BMP4 expression and the biological behavior of gliomas in order to lay a foundation for the management of these tumors.

Methods: A total of 630 patients with glioma were enrolled in the study from January 2002 to January 2008. The expression status of BMP4 in gliomas was evaluated by RT-PCR and immunohistochemistry. The relationships between BMP4 expression and clinicopathological parameters and between BMP4 expression and prognosis were also studied.

Results: The expression of BMP4 in tumor tissues was significantly lower than that in the paracancer tissues at both mRNA and protein levels (P = 0.01 and 0.001, respectively). Univariate analysis showed that BMP4 expression was closely related to extent of resection, Ki-67 expression, and the WHO grade (P = 0.001, 0.001, and 0.001, respectively), but it was not related to age, sex, or the Karnofsky Performance Status (KPS) score (P = 0.099, 0.472, and 0.201, respectively). Finally, Ki-67 expression and the WHO grade were found to be related to BMP4 expression using logistic regression (P = 0.001 and 0.001, respectively). Interestingly, we found that the expression of BMP4 was significantly related to distant glioma metastasis. Cox regression analysis identified the KPS score, extent of resection, Ki-67 expression, WHO grade, and BMP4 expression as independent prognostic factors (P = 0.044, 0.010, 0.002, 0.001, and 0.001, respectively).

Conclusions: BMP4 is differentially expressed in glioma patients and is closely related to the biological behavior of gliomas. BMP4 expression was found to be a strong predictor of distant metastasis and postoperative prognosis.

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Figures

Figure 1
Figure 1
RT-PCR analysis showed that BMP4 mRNA was upregulated in paracancer tissues compared with low-grade or high-grade glioma tissues (P = 0.01).
Figure 2
Figure 2
Western blot analysis showed that BMP4 protein was upregulated in paracancer tissues (No. 1, 2) compared with glioma tissues and in low-grade glioma tissues (No. 3, 4)compared with high-grade glioma tissues (No. 5, 6) (P = 0.001).
Figure 3
Figure 3
Expression of BMP4 in glioma tissues (×400). (A) Low-grade glioma stained for BMP4; (B) high-grade gliomas stained for BMP4.
Figure 4
Figure 4
Survival analysis of prognostic factors of glioma. KPS score (A), extent of resection (B), Ki-67 expression (C), WHO grade (D), and BMP4 expression (E) as independent prognostic factors (P = 0.02, 0.001, 0.001, 0.001, and 0.001, respectively).
See this image and copyright information in PMC

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