Khalafi Mohammad, Dartora William J, McIntire Laura Beth J, Butler Tracy A, Wartchow Krista M, Hojjati Seyed Hani, Razlighi Qolamreza R, Shirbandi Kiarash, Zhou Liangdong, Chen Kewei, Xi Ke, Banerjee Samprit, Foldi Nancy, Pahlajani Silky, Glodzik Lidia, Li Yi, de Leon Mony J, Chiang Gloria C
Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, New York, USA.
Lipidomics and Biomarker Discovery Lab, Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, New York, USA.
Alzheimers Dement. 2025 Feb;21(2):e14458. doi: 10.1002/alz.14458. Epub 2024 Dec 23.
Our review summarizes the diagnostic accuracy of plasma and cerebrospinal fluid (CSF) phosphorylated tau 217 (p-tau217) in detecting amyloid and tau pathology on positron emission tomography (PET). We systematically reviewed studies that reported the diagnostic accuracy of plasma and CSF p-tau217, searching MEDLINE/PubMed, Scopus, and Web of Science through August 2024. The accuracy of p-tau217 in predicting amyloid and tau pathology on PET was evaluated in 30 studies. Both plasma and CSF p-tau217 effectively detect amyloid and tau PET deposition. Plasma p-tau217 showed 82% sensitivity for detecting amyloid and 83% for tau, with 86% and 83% specificity, respectively. CSF p-tau217 had 79% sensitivity for amyloid and 91% for tau, with 91% and 84% specificity. p-tau217 effectively identifies Alzheimer's disease (AD) pathology. Plasma p-tau217 was comparable to CSF p-tau217 in detecting amyloid deposition on PET. Despite being less sensitive for detecting tau deposition on PET, plasma p-tau217 can be an efficient screening tool for underlying AD pathology. HIGHLIGHTS: Plasma phosphorylated tau 217 (p-tau217) serves as a viable biomarker alternative to cerebrospinal fluid p-tau217 due to the strong concordance between their results. Plasma p-tau217 accurately identifies amyloid and tau positron emission tomography (PET) positivity, exhibiting a low rate of false negatives and positives, thereby establishing it as a reliable diagnostic tool for Alzheimer's disease (AD). Plasma p-tau217 demonstrates slightly higher accuracy in predicting amyloid PET positivity compared to tau PET positivity. Plasma p-tau217 demonstrates higher predictive accuracy in detecting AD pathology among cognitively impaired individuals, compared to cognitively unimpaired individuals, suggesting its enhanced utility as a diagnostic biomarker in clinical settings.
我们的综述总结了血浆和脑脊液（CSF）中磷酸化tau 217（p-tau217）在正电子发射断层扫描（PET）中检测淀粉样蛋白和tau病理的诊断准确性。我们系统地回顾了报告血浆和脑脊液p-tau217诊断准确性的研究，通过检索MEDLINE/PubMed、Scopus和Web of Science截至2024年8月的数据。30项研究评估了p-tau217在预测PET上淀粉样蛋白和tau病理的准确性。血浆和脑脊液p-tau217均能有效检测淀粉样蛋白和tau PET沉积。血浆p-tau217检测淀粉样蛋白的敏感性为82%，检测tau的敏感性为83%，特异性分别为86%和83%。脑脊液p-tau217检测淀粉样蛋白的敏感性为79%，检测tau的敏感性为91%，特异性分别为91%和84%。p-tau217能有效识别阿尔茨海默病（AD）病理。血浆p-tau217在检测PET上的淀粉样蛋白沉积方面与脑脊液p-tau217相当。尽管血浆p-tau217在检测PET上的tau沉积时敏感性较低，但它可以作为潜在AD病理的有效筛查工具。要点：由于血浆磷酸化tau 217（p-tau217）与脑脊液p-tau217结果高度一致，它可作为脑脊液p-tau217的可行生物标志物替代物。血浆p-tau217能准确识别淀粉样蛋白和tau正电子发射断层扫描（PET）阳性，假阴性和假阳性率低，从而确立其为阿尔茨海默病（AD）的可靠诊断工具。与tau PET阳性相比，血浆p-tau217在预测淀粉样蛋白PET阳性方面显示出略高的准确性。与认知未受损个体相比，血浆p-tau217在认知受损个体中检测AD病理的预测准确性更高，表明其在临床环境中作为诊断生物标志物的效用增强。
