González-García S, González-Quevedo A, Peña-Sánchez M, Menéndez-Saínz C, Fernández-Carriera R, Arteche-Prior M, Pando-Cabrera A, Fernández-Concepción O
Departamento de Neurobiología Instituto de Neurología y Neurocirugía, Calle 29 esquina D. Vedado, Habana CP 10400, Cuba.
J R Coll Physicians Edinb. 2012;42(3):199-204. doi: 10.4997/JRCPE.2012.302.
The high sensitivities and specificities reported for blood biomarkers as a supportive test in the diagnosis of acute stroke do not correspond with their performance for decision-making in emergency situations.
Seventy-two patients with suspected stroke were recruited: 44 with ischaemic stroke, 17 with haemorrhagic stroke and 11 stroke mimics, as well as a high-risk control group of 79 individuals. Serum neuron-specific enolase (NSE) and S100 calcium binding protein B (S100B) biomarker levels were determined on admission, using immunoassay kits. The sensitivities and specificities of NSE and S100B for distinguishing acute stroke from stroke mimics and high-risk controls were calculated.
For cut-off values (NSE ≤ 14 micrograms per litre and S100B ≤130 nanograms per litre) the sensitivity was 53% and 55% respectively. Specificity was 64 for both versus the stroke mimic group. Specificity was higher (79% and 86% respectively) when calculated on the basis of the control group.
This study supports the evidence indicating that serum levels of NSE and S100B do not improve the diagnosis of acute stroke.
作为急性卒中诊断辅助检查的血液生物标志物所报道的高敏感性和特异性，与它们在紧急情况下用于决策的性能并不相符。
招募了72例疑似卒中患者：44例缺血性卒中患者、17例出血性卒中患者和11例类卒中患者，以及79名个体组成的高危对照组。入院时使用免疫分析试剂盒测定血清神经元特异性烯醇化酶（NSE）和S100钙结合蛋白B（S100B）生物标志物水平。计算NSE和S100B区分急性卒中和类卒中和高危对照组的敏感性和特异性。
对于临界值（NSE≤14微克/升和S100B≤130纳克/升），敏感性分别为53%和55%。与类卒中组相比，两者的特异性均为64。基于对照组计算时，特异性更高（分别为79%和86%）。
本研究支持了表明NSE和S100B血清水平不能改善急性卒中诊断的证据。
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