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Hyperglycemia is associated with poor survival in primary central nervous system lymphoma patients

Hyperglycemia is associated with poor survival in primary central nervous system lymphoma patients

Tumori 2017; 103(3): 272 - 278

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000590

Authors

Ayumi Debata, Koichi Yoshida, Kenta Ujifuku, Haruna Yasui, Kensaku Kamada, Daisuke Niino, Takayuki Matsuo

Abstract

Purpose

Primary central nervous system lymphoma (PCNSL) is a type of non-Hodgkin lymphoma (NHL), and it has been postulated that metabolic disorder may contribute to NHL etiology. We retrospectively investigated the prognostic significance of hyperglycemia in patients with PCNSL. We evaluated glucose transporter type 1 (GLUT1) expression by immunohistochemistry and analyzed its association with hyperglycemia and survival.

Methods

The medical and neuroradiologic records of 50 patients with PCNSL at our institution over the past 15 years were analyzed. Patients were divided into 3 groups based on mean fasting plasma glucose (FPG) levels: normal (<110 mg/dL), prediabetes (110-125 mg/dL), and diabetes (≥126 mg/dL). We defined prediabetes and diabetes groups as hyperglycemia.

Results

Forty-four percent of patients were in the prediabetes and diabetes groups. One-year survival rates were 73%, 66%, and 43% in normal, prediabetes, and diabetes groups, respectively. Univariate analysis revealed that high age, female sex, poor performance status, high mean FPG, and monotherapy were associated with shorter survival. Multivariable Cox regression analyses showed that high mean FPG and monotherapy were significant predictors of shorter survival (p = 0.036 and p = 0.000, respectively). The GLUT1 immunohistopathologic staining was performed in 34 cases, 20 of which (58%) showed variable levels of GLUT1 expression at the cell membrane and/or cytoplasm. Prediabetes and diabetes groups had a higher percentage of GLUT1-positive cells compared with the normal group (p = 0.015).

Conclusions

These findings indicate that hyperglycemia is associated with poor survival. The putative biological mechanism might involve differential GLUT1 expression between hyperglycemic and normal states in patients with PCNSL.

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki - Japan
  • Department of Pathology, Nagasaki University, Nagasaki - Japan
  • Nagasaki Educational and Diagnostic Center of Pathology, Nagasaki - Japan

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