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Journal of Neurosurgical Sciences 2019 Sep 23

DOI: 10.23736/S0390-5616.19.04715-5


lingua: Inglese

Association between pre-operative serum lactate concentrate with tumour cell proliferative index in primary brain tumour

Felipe MALDONADO 1, Neus FÁBREGAS 2, Iban ALDECOA 3, Josep GONZÁLEZ 4, Marta GARCÍA 2, Isabel BELDA 2, Paola HURTADO 2, Isabel GRACIA 2, Nicolás de RIVA 2, Javier TERCERO 2, Enrique CARRERO 2, Ricard VALERO 2

1 Department of Anaesthesiology and Perioperative Medicine, Faculty of Medicine, Hospital Clínico Universidad de Chile, University of Chile, Santiago, Chile; 2 Department of Anaesthesiology, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; 3 Department of Pathology-Brain Bank, Hospital Clinic de Barcelona-CDB-IDIBAPS, University of Barcelona, Barcelona, Spain; 4 Department of Neurosurgery, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain


BACKGROUND: Elevated preoperative lactate levels have been reported in patients admitted for resection of brain tumors. As histologic type and tumor grade have also been linked to lactate concentration, we hypothesized that preoperative lactate concentration in patients with brain tumors may be associated with tumor proliferation. We describe the relationship between preoperative plasma lactate levels, and the cell proliferation marker Ki-67 in brain tumor surgery.
METHODS: In this cross-sectional study, records of patients who underwent craniotomy between June 2017 and February 2018 at our Hospital were reviewed to select glioma and meningioma cases in which lactate concentrations in plasma and degree of cell proliferation were registered. Bivariable and linear regression analyses were used to assess the association between lactate concentrations and the Ki-67 index.
RESULTS: Lactate concentrations in plasma and Ki-67 index were available in 55 patients. Meningioma cases had a mean concentration of 1.2 (0.1) mmol/L compared to diffuse astrocytic and oligodendroglial tumours cases with 1.7 (0.1) mmol/L (p<.01). Both variables had a low positive correlation in meningiomas (Spearman’s r, 0.29; 95% CI, -0.10-0.61; p=.13) and a high correlation in gliomas (Spearman’s r, 0.64; 95% CI, 0.33-0.82; p<.01). The pooled analysis showed a high correlation index (Spearman’s r, 0.61; 95% CI, 0.40-0.76; p<.01). A linear regression model showed that the Ki-67 index explained 43% of the variation in lactate (p<.01).
CONCLUSIONS: Brain tumors with higher rates of cell proliferation have higher plasma lactate levels. In this scenario, lactate concentrations may not only reflect systemic perfusion.

KEY WORDS: Lactate; Cell proliferation; Ki-67; Brain neoplasms; Gliomas

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