Department of Medicine, Division of Neurology, The Ottawa Hospital, University of Ottawa, 1053 Carling Ave, Room ES-08, Ottawa, M5G 2C4, Ontario, Canada.
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Muscle Nerve. 2019 Aug;60(2):180-183. doi: 10.1002/mus.26488. Epub 2019 May 17.
Recent literature has concluded that cerebrospinal fluid total protein (CSF-TP) upper reference limits (URL) should be higher than 45 mg/dl and stratified by age.
Data-driven URLs were applied to the analysis of a cohort of patients with correctly and incorrectly diagnosed chronic inflammatory demyelinating polyneuropathy (CIDP). Descriptive statistics were calculated, and exploratory analyses were used to test the impact of different CSF-TP URLs on sensitivity and specificity of CIDP diagnosis.
The adoption of higher and age-dependent CSF-TP URLs reduced the sensitivity of CSF analysis slightly (from 95% to 84%-86%); however, the overall CIDP detection rate was unchanged. Twelve of 36 (33%) false-positive diagnoses occurred with CSF-TP elevation as the sole supportive criteria. By applying updated CSF-TP URLs, the specificity of CSF analysis increased from 39% to 57%-64%.
Implementation of data-driven CSF-TP URLs improves CIDP diagnostic specificity without compromising sensitivity, thereby lessening CIDP misdiagnosis. Muscle Nerve 60: 180-183, 2019.
最近的文献得出结论，脑脊液总蛋白（CSF-TP）的上参考限值（URL）应高于 45mg/dl，并按年龄分层。
将数据驱动的 URL 应用于一组正确和不正确诊断的慢性炎症性脱髓鞘性多发性神经病（CIDP）患者的分析。计算描述性统计数据，并进行探索性分析以测试不同 CSF-TP URL 对 CIDP 诊断敏感性和特异性的影响。
采用更高和年龄依赖性的 CSF-TP URL 略微降低了 CSF 分析的敏感性（从 95%降至 84%-86%）；然而，总体 CIDP 检出率保持不变。12 例（33%）假阳性诊断仅因 CSF-TP 升高而发生。通过应用更新的 CSF-TP URL，CSF 分析的特异性从 39%提高到 57%-64%。
实施数据驱动的 CSF-TP URL 可提高 CIDP 诊断的特异性而不影响敏感性，从而减少 CIDP 的误诊。肌肉神经 60: 180-183, 2019.
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