Do phosphatase of regenerating liver‑3, matrix metalloproteinases‑2, matrix metalloproteinases‑9, and epidermal growth factor receptor‑1 predict response to therapy and survival in glioblastoma multiforme.

ABSTRACT

Context Poor survival of the glioblastoma multiforme (GBM) has been attributed in part to the invasive nature of the lesion making complete surgical removal near impossible. Phosphatase of regenerating liver‑3 (PRL‑3), matrix metalloproteinases‑2 and ‑9 (MMP‑2 and MMP‑9), and epidermal growth factor receptor (EGFR‑1) play a role in invasive nature of tumor cells. Aims: This study was conducted to evaluate PRL‑3, MMP‑2, MMP‑9, and EGFR‑1 (markers) expression in cases to GBM and to correlate their expression with therapy response and survival. Settings and Design: GBM cases (n = 62) underwent surgery followed by radiation (n = 34) and chemoradiation (n = 28). Using WHO Response Evaluation Criteria in Solid Tumors criteria response to therapy was assessed at 3 months and cases followed up for survival. Subjects and Methods: Expression of markers was assessed by immunohistochemistry as a percentage of positive tumor cells in hot spots. Statistical Analysis Used Kaplan–Meier, ANOVA, Chi‑square test, univariate, and multivariate Cox‑regression analysis was done. Results: Response to therapy was evident in 54.8% cases of responders with the mean survival of 494.03 ± 201.13 days and 45.2% cases of non responders (278.32 ± 121.66 days) with P = 0.001. Mean survival for the patient’s opted chemoradiation was 457.43 ± 222.48 days which was approximately 3 months greater than those who opted radiation alone (P = 0.029). We found PRL‑3 overexpression was an independent, significant, poor prognostic factor for survival by multivariate analysis (P = 0.044). Cases negative for MMP’s and EGFR showed increased survival, but the difference was insignificant. Conclusion: PRL‑3 expression appears to be related to an adverse disease outcome.