| Rapid, accurate and non-invasive detection of cerebrospinal fluid leakage using combined determination of beta-trace protein in secretion and serum. | |
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MedLine Citation:
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PMID: 15563887 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: beta-Trace protein (Btp) has been proposed as a valuable marker of cerebrospinal fluid (CSF) leakage overcoming the drawbacks of beta-2-transferrin (B-2Tr) determination. However, there is still controversy about the appropriate cut-offs to be used (range 0.35-6 mg/L). The aim of the study was to evaluate cut-offs of Btp determination for detection CSF leakage. Further, we assessed whether the Btp secretion to serum ratio (Btp-sec/ser-ratio) would add diagnostic value. METHODS: Prospective study in patients with suspected CSF leakage. Quantitative determination of Btp in secretion and serum (Dade-Behring) and qualitative measurement of B-2-Tr in secretion and serum. Results were assessed in view of clinical data. Cut-offs and diagnostic characteristics were determined by ROC analysis. RESULTS: A total of 176 samples were assessed originating from 105 patients. In 43 samples CSF leakage could be confirmed. Sensitivity of B-2-Tr was 84%, specificity amounted to 100%. The area under the curve (AUC) for Btp-measurement in secretion was 0.98. At a cut-off of 0.68 mg/L, sensitivity was 100% and specificity 91%. At a cut-off of 1.11 mg/L, the specificity was 100% with a sensitivity of 93%. The Btp-sec/ser-ratio has an AUC of 0.99. Combining a 0.68 mg/L cut-off in secretion with a Btp-sec/ser-ratio cut-off of 4.9 reveals a sensitivity of 99% and a specificity of 100%. CONCLUSIONS: Btp is a rapid and accurate marker for the presence of CSF leakage. Combining measurement of Btp in secretion together with determination of the Btp-sec/ser-ratio enhances the diagnostic characteristics of the Btp assay. Determination of Btp in both serum and secretion is thus recommended. |
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Authors:
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Lorenz Risch; Ivan Lisec; Markus Jutzi; Michael Podvinec; Hans Landolt; Andreas R Huber |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinica chimica acta; international journal of clinical chemistry Volume: 351 ISSN: 0009-8981 ISO Abbreviation: Clin. Chim. Acta Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2004-11-26 Completed Date: 2005-04-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1302422 Medline TA: Clin Chim Acta Country: Netherlands |
Other Details:
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Languages: eng Pagination: 169-76 Citation Subset: IM |
Affiliation:
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Clinical Decision Making Research Unit, Vorarlberg Institute of Vascular Investigation and Treatment, Academic Teaching Hospital, Feldkirch, Austria. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Biological Markers Cerebrospinal Fluid / physiology* Craniocerebral Trauma / cerebrospinal fluid* Ear / injuries Female Humans Intramolecular Oxidoreductases / blood, cerebrospinal fluid* Lipocalins Male Middle Aged Nephelometry and Turbidimetry Neurosurgical Procedures Nose / injuries Prospective Studies ROC Curve Skull Fractures / cerebrospinal fluid, radiography Transferrin / cerebrospinal fluid |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Lipocalins; 11096-37-0/Transferrin; EC 5.3.-/Intramolecular Oxidoreductases; EC 5.3.99.2/prostaglandin R2 D-isomerase |
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