Periostin is a new potential prognostic biomarker for glioma

The objective of this study is to investigate the expression level of periostin in cancer stem cells as well as in the glioma tissues and the relationship between periostin expression and clinical and pathological characteristics and prognosis of gliomas. ESA+/CD133+/lin- tumor cells were selected by flow cytometry from glioma tissues, and the periostin expression in ESA+/CD133+/lin- tumor cells and non-ESA+/CD133+/lin- tumor cells was detected by quantitative real-time polymerase chain reaction (RT-PCR) and Western blot analysis. The expression status of periostin in glioma tissues was analyzed by immunohistochemistry staining, and the relationship between periostin and clinicopathological parameters of gliomas was determined. It showed that periostin is expressed higher in ESA+/CD133+/lin- tumor cells compared to non-ESA+/CD133+/lin- tumor cells in both mRNA and protein levels. One hundred eighteen (37.82 %) glioma patients were observed with highly expressed periostin protein in immunohistochemistry. Moreover, we observed that the expression of periostin protein was related to Karnofsky performance scale score (KPS), extent of resection, Ki67, and WHO grade of gliomas in universal analysis (P=0.008, 0.045, 0.001, and 0.001, respectively). However, only WHO grade was identified to be related to periostin expression in gliomas after multivariate analysis. After survival analysis, the cases with highly expressed periostin protein attained a significantly poorer postoperative disease-specific survival and distant metastasis than those with none/low expressed periostin protein (P=0.001 and 0.002). In the Cox regression test, KPS, extent of resection, Ki67, WHO grade, and periostin were detected as the independent prognostic factors (P=0.008, 0.007, 0.032, 0.001, and 0.001, respectively). Periostin can be an important prognostic marker for gliomas, which may present a new therapeutic target for glioma patients.