Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 30:13:601.
doi: 10.25259/SNI_889_2022. eCollection 2022.

Clinical utility of serum glial fibrillary acidic protein in glial neoplasm

Nidhi Yadav  1 , Keshav Mishra  1 , Anil Kumar B C  1 , Daljit Singh  1 , Manju Subberwal  2
Affiliations

Clinical utility of serum glial fibrillary acidic protein in glial neoplasm

Nidhi Yadav et al. Surg Neurol Int. .

Abstract

Background: Glial fibrillary acidic protein (GFAP) is a member of the cytoskeletal protein family and is widely expressed in astroglial and neural stem cells, also in glial tumors such as astrocytoma and Glioblastoma (GBM). Increased GFAP expression and disruption of the blood-brain barrier are the characteristic features of GBM. Higher serum GFAP levels can help differentiate GBM from GBM mimics (such as primary central nervous system lymphoma, metastasis, or demyelinating lesions).

Methods: This prospective study was carried out in a tertiary care center in the department of neurosurgery on newly diagnosed glioma patients who underwent surgery from January 2018 to July 2019, excluded patients with history of the previous surgery for glioma, traumatic brain injury, and ischemic or hemorrhagic stroke. The blood sample was obtained at admission before undergoing invasive procedure. Pathological examination of the tumor biopsy sample was carried out using classical hematoxylin-eosin and immunohistochemical staining. All statistical analyses were performed using SPSS version 24.0.

Results: The mean preoperative tumor volume was 40 cm3 (range 17.19-65.57 cm3; standard deviation [SD] = 9.99 cm3) which showed 98.25% mean reduction in volume postsurgery (mean tumor volume = 0.7 cm3; SD = 0.19 cm3). Preoperative serum GFAP measurements show higher levels (spearman's rho coefficient = 0.610 with P = 0.000) with increasing grade of tumor. GFAP levels also demonstrated higher value with increasing preoperative tumor volume.

Conclusion: Increasing serum GFAP levels in the preoperative period correlate with higher tumor grade, especially grade III and grade IV tumors. The serum GFAP levels showed relation to tumor volume, both before and after surgery.

Keywords: Central Nervous System( CNS); Glial fibrillary acidic protein (GFAP); Glioblastoma (GBM); Magnetic Resonance Imaging ( MRI).

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Serial variation in serum glial fibrillary acidic protein levels from preoperative period to immediate and 3-month postoperative period.
Figure 2:
Figure 2:
Relation of serum glial fibrillary acidic protein levels with the WHO grade I–IV of glial neoplasm.
Figure 3:
Figure 3:
(a) Scatter plot showing relation of preoperative serum glial fibrillary acidic protein (GFAP) levels with preoperatively tumor volume, (b) scatter plot showing relation of postoperative serum GFAP levels with immediate postoperative tumor volume, and (c) scatter plot showing relation of serum GFAP levels and tumor volume at 3-month postoperative follow-up.
Figure 4:
Figure 4:
Receiver operating characteristic (ROC) curve showing the cutoff level for serum glial fibrillary acidic protein level for glioblastoma.
See this image and copyright information in PMC

References

    1. Bazarian JJ, Biberthaler P, Welch RD, Lewis LM, Barzo P, Bogner-Flatz V, et al. Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): A multicentre observational study. Lancet Neurol. 2018;17:782–9. - PubMed
    1. Diagnostic Accuracy of Plasma Glial Fibrillary Acidic Protein for Differentiating Intracerebral Hemorrhage and Cerebral Ischemia in Patients with Symptoms of Acute Stroke Clinical Chemistry Oxford Academic. Available from: https://www.academic.oup.com/clinchem/article/58/1/237/5620623?login=false [Last accessed on 2022 Sep 18] - PubMed
    1. Diaz-Arrastia R, Wang KK, Papa L, Sorani MD, Yue JK, Puccio AM, et al. Acute biomarkers of traumatic brain injury: Relationship between plasma levels of ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein. J Neurotrauma. 2014;31:19–25. - PMC - PubMed
    1. Eng LF, Ghirnikar RS, Lee YL. Glial fibrillary acidic protein: GFAP-thirty-one years (1969-2000) Neurochem Res. 2000;25:1439–51. - PubMed
    1. Gállego Pérez-Larraya J, Paris S, Idbaih A, Dehais C, Laigle-Donadey F, Navarro S, et al. Diagnostic and prognostic value of preoperative combined GFAP, IGFBP-2, and YKL-40 plasma levels in patients with glioblastoma. Cancer. 2014;120:3972–80. - PubMed

LinkOut - more resources