使用脑脊液 YKL-40 进行阿尔茨海默病的两水平诊断分类。

Two-level diagnostic classification using cerebrospinal fluid YKL-40 in Alzheimer's disease.

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l'hôpital, Paris, France.

Faculty of Medicine, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Alzheimers Dement. 2017 Sep;13(9):993-1003. doi: 10.1016/j.jalz.2017.01.021. Epub 2017 Mar 3.

DOI:10.1016/j.jalz.2017.01.021

PMID:28263742

Abstract

INTRODUCTION

We assessed the diagnostic accuracy of cerebrospinal fluid (CSF) YKL-40 in discriminating (1) clinical Alzheimer's disease (AD) from cognitively healthy controls (HCs) and frontotemporal dementia (FTD) (level I) and (2) patients stratified by different pathophysiological profiles from HCs and FTD following a novel unbiased/descriptive categorization based on CSF biomarkers, independent of cognitive impairment severity (level II).

METHODS

YKL-40 was compared among HCs (n = 21), mild cognitive impairment (n = 41), AD (n = 35), and FTD (n = 9) (level I) and among HCs (n = 21), AD pathophysiology (tau and amyloid β) negative (n = 15), tau positive (n = 15), amyloid β positive (n = 13), AD pathophysiology positive (n = 33), and FTD (n = 9) (level II).

RESULTS

Level I: YKL-40 discriminated AD from HC and FTD (area under the receiver operating characteristic curves [AUROCs] = 0.69, 0.71). Level II: YKL-40 discriminated tau-positive individuals and AD pathophysiology-positive individuals from HC, AD pathophysiology-positive patients from FTD (AUROCs = 0.76, 0.72, 0.73).

DISCUSSION

YKL-40 demonstrates fair performance in distinguishing tau-positive patients from HCs, suggesting it may aid clinical diagnosis and support a biomarker-guided pathophysiological stratification.

摘要

简介

我们评估了脑脊液（CSF） YKL-40 在区分（1）临床阿尔茨海默病（AD）与认知健康对照（HC）和额颞叶痴呆（FTD）（I 级），以及（2）基于新型无偏/描述性分类的 CSF 生物标志物，独立于认知障碍严重程度（II 级），从 HC 和 FTD 分层的不同病理生理特征的患者中的诊断准确性。

方法

在 I 级中，比较了 HC（n=21）、轻度认知障碍（n=41）、AD（n=35）和 FTD（n=9）之间的 YKL-40 水平，以及在 II 级中，比较了 HC（n=21）、AD 病理生理学（tau 和淀粉样蛋白β）阴性（n=15）、tau 阳性（n=15）、淀粉样蛋白β阳性（n=13）、AD 病理生理学阳性（n=33）和 FTD（n=9）之间的 YKL-40 水平。

结果

I 级：YKL-40 区分了 AD 与 HC 和 FTD（接受者操作特征曲线下面积[AUROCs]分别为 0.69 和 0.71）。II 级：YKL-40 区分了 tau 阳性个体和 AD 病理生理学阳性个体与 HC，AD 病理生理学阳性患者与 FTD（AUROCs 分别为 0.76、0.72 和 0.73）。