Malignant gliomas--
glioblastoma multiforme and
anaplastic astrocytoma--are among the most fatal forms of
cancer in humans. It has been suggested that
hepatocyte growth factor (HGF) is a reliable predictor of
glioma malignancy; amounts of HGF are directly related to cellular proliferation, angiogenesis, low apoptotic rate, and poor prognosis (WHO III and IV). We measured the HGF content of cerebrospinal fluid (CSF) from patients with
malignant glioma glioblastoma multiforme (WHO IV; n = 14),
anaplastic astrocytoma (WHO III; n = 4), and
meningioma (WHO I; n = 9), and from control subjects (n = 25), and found a high concentration of HGF in patients with
malignant glioma. However, CSF concentrations from
glioblastoma multiforme and
anaplastic astrocytoma patients were not statistically significantly different (893 +/- 157 vs. 728 +/- 61, respectively; P > 0.01). A negative correlation between HGF and survival was found at five years of follow-up (R = -0.922, R (2) = 0.850, P < 0.001). Also, the HGF concentration in CSF was a reliable means of explaining the highly variable survival of patients with
malignant glioma. CSF concentrations of HGF higher than 500 pg/ml were associated with increased mortality whereas values higher than 850 pg/ml were associated with a brief
tumor-free period after surgery (9 +/- 0.6 vs. 6 +/- 0.6 months, respectively, P < 0.001). Our findings support the idea that measurement of HGF in CSF could be a useful tool for monitoring the biological activity of
malignant glioma. The findings will ultimately need to be confirmed in a much larger study.