Evaluating EFEMP1 in Cerebrospinal Fluid and Serum as a Potential Diagnosis Biomarker for Meningiomas

Background: The aim of this study was to determine the cerebrospinal fluid (CSF) and serum levels of EGF containing fibulin-like extracellular matrix protein 1 (EFEMP1) in the patients with meningiomas and explore its potential as a biomarker. Methods: Forty-five patients with meningioma, 11 of whom underwent meningioma resection, as well as 30 healthy controls were enrolled in this study. CSF and blood samples were collected preoperatively and postoperatively. Expression levels of EFEMP1 were measured by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curves were used to evaluate its discriminant ability. Results: CSF EFEMP1 levels were significantly higher in the CSF samples (p < 0.0001) and serum samples (p = 0.0056) of meningioma patients compared to controls. To distinguish meningioma patients from controls by CSF and serum EFEMP1 levels, ROC/AUC analysis indicated an AUC of 0.945 (sensitivity 0.933; specificity 0.833) and an AUC of 0.674 (sensitivity 0.867; specificity 0.400), respectively. Moreover, the postoperative CSF levels of EFEMP1 were significantly decreased compared to the preoperative levels (p < 0.0001). Conclusions: The present study suggested that elevated EFEMP1 levels might be a novel diagnostic biomarker for meningioma patients.