Thai Red Cross Emerging Infectious Diseases Health Science Centre, World Health Organization Collaborating Centre for Research and Training on Viral Zoonoses, King Chulalongkorn Memorial Hospital The Thai Red Cross Society, Bangkok, Thailand.
Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Alzheimers Dement. 2023 Jun;19(6):2745-2749. doi: 10.1002/alz.13022. Epub 2023 Mar 16.
Despite the substantial accuracy of plasma p-tau in diagnosing Alzheimer's disease (AD) in research cohorts, data on real-life memory clinic patients are lacking.
Memory clinic patients at their early symptomatic stages were prospectively enrolled to undergo routine clinical assessment, plasma p-tau181 quantification (Simoa), amyloid and tau-positron emission tomography (PET). The diagnostic performance of plasma p-tau181, neurocognitive specialists, and regional tau-PET were compared head-to-head using amyloid-PET as the reference standard.
Plasma p-tau181 has the area under the curve (AUC), sensitivity, specificity, and accuracy of 0.84 (95% confidence interval [CI] 0.73-0.94), 0.80 (95% CI 0.64-0.90), 0.75 (95% CI 0.51-0.90), and 0.78 (95% CI 0.65-0.88) for detecting amyloid-PET positivity in early symptomatic patients, respectively. The AUC of clinical diagnosis and tau-PET were 0.70 (95% CI 0.56-0.85) and 0.88 (95% CI 0.79-0.97), respectively.
Plasma p-tau181 also performed well in real-life memory clinic settings and its role in clinical practice is supported.
尽管血浆 p-tau 在研究队列中诊断阿尔茨海默病（AD）的准确性很高，但缺乏关于现实生活中记忆诊所患者的数据。
早期有症状的记忆诊所患者前瞻性入组，接受常规临床评估、血浆 p-tau181 定量（Simoa）、淀粉样蛋白和 tau 正电子发射断层扫描（PET）。使用淀粉样蛋白-PET 作为参考标准，对头对头比较血浆 p-tau181、神经认知专家和区域 tau-PET 的诊断性能。
血浆 p-tau181 的曲线下面积（AUC）、敏感性、特异性和准确性分别为 0.84（95%置信区间 [CI] 0.73-0.94）、0.80（95% CI 0.64-0.90）、0.75（95% CI 0.51-0.90）和 0.78（95% CI 0.65-0.88），用于检测早期有症状患者的淀粉样蛋白-PET 阳性。临床诊断和 tau-PET 的 AUC 分别为 0.70（95% CI 0.56-0.85）和 0.88（95% CI 0.79-0.97）。
血浆 p-tau181 在现实生活中的记忆诊所环境中也表现良好，支持其在临床实践中的作用。
