van de Langerijt B, Gijtenbeek J M, de Reus H P M, Sweep F C G J, Geurts-Moespot A, Hendriks J C M, Kappelle A C, Verbeek M M
Department of Neurology, Laboratory of Pediatrics and Neurology, Radboud University Nijmegen Medical Centre, 830 LKN, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands.
Neurology. 2006 Jul 11;67(1):114-9. doi: 10.1212/01.wnl.0000223348.42106.97.
To investigate the diagnostic value of transforming growth factor beta(1) (TGFbeta(1)), vascular endothelial growth factor (VEGF), urokinase-type plasminogen activator (uPA), and tissue-type plasminogen activator (tPA) in CSF for leptomeningeal metastasis (LM).
The authors measured concentrations of biomarkers by ELISA in matched samples of CSF and serum, collected from 132 patients with a solid malignancy with LM (n = 19) and without LM (n = 54) and patients with viral (n = 16) and bacterial (n = 16) meningitis and a variety of nonmalignant, noninfectious neurologic disorders (n = 27). Indexes of the biomarkers (CSF/serum value relative to CSF/serum albumin ratios) were calculated to correct for the serum contribution to the CSF marker concentration.
CSF VEGF concentration was significantly higher in LM than in all other groups. VEGF indexes were also higher, although not significant. In contrast, the tPA index was significantly decreased in LM compared with all other groups. The combination of the VEGF and tPA indexes resulted in a sensitivity of 100% for LM and a specificity of 73% for the patient group with a primary tumor but without LM.
Patients with leptomeningeal metastasis have high vascular endothelial growth factor (VEGF) indexes and low tissue-type plasminogen activator (tPA) indexes. As cytologic examination of CSF lacks 100% sensitivity for the diagnosis of leptomeningeal metastasis (LM), the combination VEGF and tPA index analysis may be of additional value in the diagnostic workup of patients suspected of having LM.
探讨脑脊液中转化生长因子β1（TGFβ1）、血管内皮生长因子（VEGF）、尿激酶型纤溶酶原激活剂（uPA）和组织型纤溶酶原激活剂（tPA）对软脑膜转移（LM）的诊断价值。
作者采用酶联免疫吸附测定法（ELISA）检测了132例患者配对的脑脊液和血清样本中生物标志物的浓度，这些患者包括患有实体恶性肿瘤且发生LM的患者（n = 19）和未发生LM的患者（n = 54），以及患有病毒性脑膜炎（n = 16）、细菌性脑膜炎（n = 16）和各种非恶性、非感染性神经系统疾病的患者（n = 27）。计算生物标志物的指数（相对于脑脊液/血清白蛋白比值的脑脊液/血清值），以校正血清对脑脊液标志物浓度的影响。
LM患者脑脊液VEGF浓度显著高于所有其他组。VEGF指数也较高，尽管不显著。相比之下，与所有其他组相比，LM患者的tPA指数显著降低。VEGF和tPA指数联合使用时，对LM的敏感性为100%，对患有原发性肿瘤但未发生LM的患者组的特异性为73%。
软脑膜转移患者具有高血管内皮生长因子（VEGF）指数和低组织型纤溶酶原激活剂（tPA）指数。由于脑脊液细胞学检查对软脑膜转移（LM）的诊断缺乏100%的敏感性，VEGF和tPA指数联合分析可能在疑似LM患者的诊断检查中具有额外价值。
