Changes in plasma IL-6 and YKL-40 in glioma could be attributed from tumor mediated regulation of systemic immune responses, as previously suggested for IL-6 (10, 47, 48) and leakage through a damaged blood-brain barrier, but inflammatory diseases (32), steroid treatment (49), neutrophilia (50), and surgical trauma (51, 52) may also influence biomarker plasma levels. This evidence concerns the gene CHI3L1 and neoplasm.