The analysis of tumor cells or circulating neoplastic cell products (liquid biopsy) is increasingly used in the context of many neoplasms. Their detection in body fluids can have diagnostic, prognostic and predictive significance. Many studies have shown that their concentration, and consequently the sensitivity of the methods used fot their identification, varies according to the different body fluids analyzed and the type of tumor analyzed. As far as brain tumors are concerned, it has been shown that the concentration of tumor cell products in the cerebrospinal fluid (CSF) is greater than in the blood and varies within the different compartments of the CNS.
Many studies have aimed to identify molecular markers typical of gliomas, however a pathognomonic “molecular signature” for this type of tumor has not yet been identified.
The liquid biopsy performed on the patient’s CSF obtained by lumbar puncture can be a valid alternative in the case of impossibility of surgical biopsy and / or in the case of diagnostic doubt between radionecrosis and disease progression.
Since CSF is the fluid most in contact with the brain tumor environment, it is evident that this constitutes the privileged target for analysis using liquid biopsy. The present study aim to determine the sensitivity and specificity of the biopsy depending on the body fluids analyzed.
The peri-lesional CSF has huge importance to identify the molecular targets that will have to be searched for in the peripheral (spinal) CSF and in the blood. For this reason, the following will be subjected to molecular analysis:
- The tumor (biopsy or surgical excision)
- Peri-tumor intracranial CSF (intra-operative sampling)
- CSF obtained by spinal tap (intra-operative sampling)
- Peripheral blood (sampling during hospitalization)
With this protocol we intend to investigate the validity of this method and its clinical applicability in patients affected by glioma.