Serum Response Factor Expression, Microvascular Density, and Postoperative Recurrence in Glioblastoma

To investigate the association between serum response factor (SRF) expression, tumour microvascular density (MVD), and postoperative recurrence in glioblastoma.

This retrospective study analysed 92 patients with histologically confirmed glioblastoma treated between July 2021 and July 2023. Tumour and adjacent normal brain tissues were collected during surgery for immunohistochemical detection of SRF and CD105. MVD was determined by counting CD105-positive microvessels in the most vascularised tumour regions. Spearman correlation assessed the association between SRF and MVD. All patients underwent maximal surgical resection and were followed for 1 year. Recurrence was defined by MRI. Multivariate logistic regression identified independent predictors of recurrence.

SRF-positive tumours were significantly more frequent than in adjacent normal brain tissue (56.5% vs 2.2%, P<0.001) and had higher MVD (86.79 ± 14.12 vs 70.58 ± 8.77 vessels/field, P<0.05). SRF expression correlated positively with MVD (r = 0.749, P<0.05). At 1 year, 24 patients (26.1%) recurred. Compared with non-recurrent cases, the recurrence group had higher rates of SRF positivity, tumour size ≥5 cm, poor differentiation, high grade, and incomplete resection (all P<0.05). Multivariate analysis identified SRF positivity, tumour size ≥5 cm, poor differentiation, high grade, and incomplete resection as independent recurrence predictors.

SRF overexpression in glioblastoma is associated with increased angiogenesis and higher recurrence risk. SRF may promote tumour proliferation, differentiation, and migration, and serve as a prognostic biomarker and potential therapeutic target.