The ratio of HLA-DR and VNN2(+) expression on CD14(+) myeloid derived suppressor cells can distinguish glioblastoma from radiation necrosis patients

作者：Soler David C; Young Andrew B; Cooper Kevin D; Kerstetter Fogle Amber; Barnholtz Sloan Jill S; Gittleman Haley; McCormick Thomas S; Sloan Andrew E

来源：Journal of Neuro-Oncology, 2017, 134(1): 189-196.

DOI：10.1007/s11060-017-2508-7

• Brain tumors
• Glioblastoma
• MDSC
• VNN2
• Liquid biopsy

Glioblastoma (GBM) is the most aggressive and lethal type of brain cancer with a median survival of less than two years even following aggressive treatment (Stupp et al., N Engl J Med 352: 987-996, 2005). Among the many challenges in treating patients with this devastating disease is the ability to differentiate Magnetic Resonance Imaging (MRI) images that appear following radiation therapy, often termed "radiation necrosis" from true GBM recurrence. Radiation necrosis (RN) and GBM are very difficult to distinguish and currently only a brain biopsy can conclusively differentiate these pathologies. In the present study, we introduce a differential diagnostic approach using a newly identified Myeloid-Derived Suppressor Cell (MDSC) biomarker, vascular non-inflammatory molecule 2 -(VNN2(+)), in combination with expression of traditional HLA-DR on peripheral blood -CD14(+) monocytes isolated from GBM and/or RN patients. We performed proof-of-principle experiments confirming the sensitivity and specificity of this approach based upon the combined expression levels of HLA-DR and VNN2 among -CD14(+) Mo-MDSC, which we called the DR-Vanin Index or DVI. The DVI was able to distinguish GBM from RN patients with a high degree of certainty (n = 18 and n = 6 respectively; p = 0.0004). This novel, quick and inexpensive blood-based liquid biopsy could potentially replace invasive brain biopsies in differentiating GBM from RN patients using a minimally-invasive technique.

• 出版日期2017-8