Takahashi Takuya, Hirai Takashi, Sumitani Masahiko, Mochizuki Takao, Akiyama Toru, Kimura Atsushi, Hayakawa Kentaro, Takasawa Eiji, Chikuda Hirotaka, Yoshii Toshitaka, Kurano Makoto
Department of Orthopedics, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Sci Rep. 2025 Jul 8;15(1):24524. doi: 10.1038/s41598-025-08715-7.
Spinal stenosis frequently involves multiple regions, particularly the cervical and lumbar spine. Therefore, it is essential to identify biomarkers that can distinguish between central and peripheral neuropathy. Lysophosphatidylcholine (LPC), a biomarker involved in neuropathic pain, has been proposed as a potential diagnostic biomarker for distinguishing these conditions. This study aimed to evaluate the diagnostic utility of LPC levels in the cerebrospinal fluid (CSF) for differentiating peripheral neuropathy from central neuropathy. This study included 198 patients: 77 with cauda equina syndrome (CES), 34 with myelopathy, and 87 controls. CSF samples were collected by lumbar puncture. Using liquid chromatography-tandem mass spectrometry, six LPC species, including (16:0), (18:0), (18:1), (18:2), (20:4), and (22:6), were measured in the CSF. These LPC levels were compared among the groups, and the cutoff levels that could efficiently discriminate between the groups with high accuracy were determined. All levels of LPC species were significantly higher in the CES and myelopathy groups than in the controls, with CES showing the highest levels. LPC (18:1) and LPC (22:6) demonstrated high diagnostic accuracy in distinguishing CES from myelopathy. LPC (18:1), LPC (18:2), LPC (20:4), and LPC (22:6) demonstrated high diagnostic accuracy in distinguishing myelopathy from controls. The LPC species levels in CSF offer a reliable biomarker for differentiating CES from myelopathy. Measuring LPC species can enhance diagnostic accuracy, enabling precise treatment strategies.
椎管狭窄常累及多个部位，尤其是颈椎和腰椎。因此，识别能够区分中枢性和周围性神经病变的生物标志物至关重要。溶血磷脂酰胆碱（LPC）是一种与神经性疼痛有关的生物标志物，已被提议作为区分这些病症的潜在诊断生物标志物。本研究旨在评估脑脊液（CSF）中LPC水平在区分周围神经病变与中枢神经病变方面的诊断效用。本研究纳入了198例患者：77例马尾综合征（CES）患者、34例脊髓病患者和87例对照者。通过腰椎穿刺采集脑脊液样本。使用液相色谱 - 串联质谱法，测定了脑脊液中六种LPC种类，包括（16:0）、（18:0）、（18:1）、（18:2）、（20:4）和（22:6）。比较了各组之间的这些LPC水平，并确定了能够高效且准确地区分各组的临界水平。CES组和脊髓病组中所有LPC种类的水平均显著高于对照组，其中CES组的水平最高。LPC（18:1）和LPC（22:6）在区分CES与脊髓病方面显示出较高的诊断准确性。LPC（18:1）、LPC（18:2）、LPC（20:4）和LPC（22:6）在区分脊髓病与对照组方面显示出较高的诊断准确性。脑脊液中的LPC种类水平为区分CES与脊髓病提供了一种可靠的生物标志物。测量LPC种类可提高诊断准确性，从而制定精确的治疗策略。
