Background Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) was found to be up-regulated in various cancers and has been identified as a potential target for cancer treatment, but the potential function of MTHFD2 in low-grade gliomas (LGG) has not been well-examined. This study initially revealed the potential function of MTHD2 and emphasized its importance in LGG. Methods We first explored the expression of MTHFD2 in LGG patients using Oncomine and UALCAN database. Survival analysis on LGG

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... tients was then conducted based on age, gender, radiation therapy, histologic grade, tumor type and MTHFD2 expression. Cox regression analysis was also applied to predict the prognostic factor for overall survival (OS) of LGG. Finally, we performed enrichment analysis to reveal the potential MTHFD2-associated pathways involved in LGG. Results We found that MTHFD2 is highly expressed in LGG patients, and MTHFD2 expression is related with age, sub-types and TP53-mutation status (all P<0.05). Age, radiation therapy, histologic grade and tumor type were implicated in the survival of LGG patients (all P<0.05). High expression of MTHFD2 desirably improved the prognosis of LGG patients (P<0.001), especially for those patients with characteristics of age≥45 years old (P<0.001), receiving radiation therapy treatment (P=0.001), sub-type of astrocytoma and oligodendroglioma (all P<0.05), and histologic grade 3 (P<0.05). MTHFD2 was determined as an independent prognostic factor with age and grade for OS of LGG patients (all P<0.01). Pathway enrichment analysis indicated that MTHFD2 mainly participates in mTOR signaling pathway, apelin pathway and folate-mediated one-carbon metabolism.Conclusions The expression of MTHFD2 is associated with key clinical phenotype. High expression of MTHFD2 is favorable for the overall survival of LGG patients. MTHFD2 may serve as a novel prognostic biomarker and potential therapeutic target for LGG treatment.