Cerebrospinal fluid top‐down proteomics evidenced the potential biomarker role of LVV‐ and VV‐hemorphin‐7 in posterior cranial fossa pediatric brain tumors

Posterior cranial fossa is the most frequent location of pediatric brain tumors. Its diagnosis is currently performed by postsurgery histopathology and the identification of biomarkers in cerebrospinal fluid (CSF) could provide a less invasive tool. Patient CSF was collected during surgery before the tumor removal (PRE‐CSF) and 6 days after the resection (POST‐CSF) and analyzed by top down LC‐MS proteomics for comparison. The PRE‐CSFs generally exhibited a less complex LC‐MS profile than the relative POST‐CSFs suggesting a suppressive role of the tumor toward proteins and peptides production or release. Particularly, a panel of peptides, identified as alpha‐ and beta‐hemoglobin chains fragments, were generally absent in the PRE‐CSF and present in the POST ones independently from contaminant blood hemoglobin. Among them, the LVV‐ and VV‐hemorphin‐7 showed the most repeatable trend and with a few remarkable exceptions: their unusual absence in POST surgery CSF was in fact interestingly correlated to the presence of tumor in the patient despite surgery due to metastases or to subtotal resection. These results ascribed a relevant biological role to LVV‐ and VV‐h7 peptides in the disease and a strong potential as biomarkers. Their analysis in POST surgery CSF could be used to predict patient prognosis.