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Serum neurofilament light chain or glial fibrillary acidic protein in the diagnosis and prognosis of brain metastases

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Abstract

Introduction

Brain metastases (BM) remains the most cumbersome disease burden in patients with lung cancer. This study aimed to investigate whether serum brain injury biomarkers can indicate BM, to further establish related diagnostic models, or to predict prognosis of BM.

Materials and methods

This was a prospective study of patients diagnosed with lung cancer with BM (BM group), with lung cancer without BM (NBM group), and healthy participants (control group). Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were detected at baseline. We identified and integrated the risk factors of BM to establish diagnostic models.

Results

A total of 158 patients were included (n = 37, 57, and 64 in the BM, NBM, and control groups, respectively). Serum biomarker levels were significantly higher in the NBM group than in the control group. Higher serum NfL and GFAP concentrations were associated with BM (odds ratios, 3.06 and 1.79, respectively). NfL (area under curve [AUC] = 0.77, p < 0.001) and GFAP (AUC = 0.64, p = 0.02) had diagnostic value for BM. The final diagnostic model included NfL level, age, Karnofsky Performance Status. The model had an AUC value of 0.83 (95% confidence interval [CI] 0.75–0.92). High NfL concentration was correlated with poor overall survival of patients with BM (hazard ratio, 3.31; 95% CI 1.22–9.04; p = 0.019).

Conclusion

Serum NfL and GFAP could be potential diagnostic biomarkers for BM in patients with lung cancer. We established a model that can provide individual diagnoses of BM. Higher NfL level may be associated with poor prognosis of patients with BM.

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Availability of data and material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

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Funding

This study was supported Fundamental and Applied Fundamental Research Project of City-School (Institute) Joint Funding Project, Guangzhou Science and Technology Bureau[202102010345], Guangdong Science and Technology Program special projects [2020A1111350025], and State Key Laboratory of Respiratory Disease-The open project [SKLRD-OP-202111].

Author information

Author notes

  1. Xinqing Lin, Tingting Lu and Haiyi Deng have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital, Guangzhou Medical University, 151# Yanjiang Road, Guangzhou, 510120, China

    Xinqing Lin, Haiyi Deng, Yilin Yang, Tao Chen, Yinyin Qin, Xiaohong Xie, Zhanhong Xie, Ming Liu, Ming Ouyang, Shiyue Li, Nanshan Zhong & Chengzhi Zhou

  2. Department of Neurology, Psychological and Neurological Diseases Research Centre, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China

    Tingting Lu, Chunxin Liu & Wei Qiu

  3. Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China

    Yong Song

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  1. Xinqing Lin
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Contributions

Study concept and design: XL, TL, HD, WQ, and CZ. Acquisition of data: HD, CL, YY, XX, and ML. Analysis and interpretation of data: XL, TL, HD, TC, and YQ. Drafting of the manuscript: XL, TL, and HD. Critical revision of the manuscript for important intellectual content: all authors. Study supervision: WQ, CZ. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Wei Qiu or Chengzhi Zhou.

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The authors declare that they have no conflicts of interest.

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Institutional review board/ethics committee approval was obtained from the Institutional Review Board of the First Affiliated Hospital of Guangzhou Medical University (Guangzhou, Guangdong, China).

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Informed consent was obtained from all individual participants for enrollment in the study.

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Lin, X., Lu, T., Deng, H. et al. Serum neurofilament light chain or glial fibrillary acidic protein in the diagnosis and prognosis of brain metastases. J Neurol 269, 815–823 (2022). https://doi.org/10.1007/s00415-021-10660-0

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  • DOI: https://doi.org/10.1007/s00415-021-10660-0

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