The Warburg effect in patients with brain tumors: a comprehensive analysis of clinical significance

• Published in: Journal of neuro-oncology 2023-10, Vol.165 (1), p.219-226
• Main Authors: Ma, Seoyoung, Lee, Hongna, Jo, Woo-Young, Byun, Yoon Hwan, Shin, Kyung Won, Choi, Seungeun, Oh, Hyongmin, Park, Chul-Kee, Park, Hee-Pyoung
• Format: Article
• Language: English
• Subjects: Aneurysm; Aneurysms; Brain cancer; Brain tumors; Clinical significance; Hyperlactatemia; Lactic acid; Medicine; Medicine & Public Health; Neurology; Oncology; Tumors
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-023-04486-1

Purpose The Warburg Effect, referring to an elevation in serum lactate level attributable to increased tumor metabolism, is present in patients with brain tumors. This study comprehensively analyzes the Warburg effect in patients undergoing brain tumor resection. Methods We retrospectively analyzed the baseline intraoperative serum lactate levels of 2,053 patients who underwent craniotomies, including 415 with cerebral aneurysms and 1,638 with brain tumors. The brain tumor group was divided into subgroups based on the tumor pathology (extra-axial and intra-axial tumor) and the WHO tumor grade (high-grade and low-grade). Results Serum lactate level was significantly higher in the tumor group than in the aneurysm group (1.98 ± 0.97 vs. 1.09 ± 0.57 mmol/L, p  2.2 mmol/L) was higher in the tumor group (33.5 vs. 3.1%, p  4.4 mmol/L) was found in 34 patients (2.1%) of only the tumor group. In patients with intra-axial tumors, serum lactate level was greater in high- than low-grade tumors (2.10 ± 1.05 vs. 1.88 ± 0.92 mmol/L, p = 0.006). Factors predictive of hyperlactatemia included supratentorial tumor location (odds ratio[95%CI] 2.926[2.127–4.025], p