The diagnostic efficiency of biomarkers in sporadic Creutzfeldt-Jakob disease compared to Alzheimer's disease
The diagnostic efficiency of biomarkers in sporadic Creutzfeldt-Jakob disease compared to Alzheimer's disease
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DOI：
10.1016/j.neurobiolaging.2008.01.013
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发表时间：
2009-11-01
影响因子：
4.2
通讯作者：
Christiansen, Michael
中科院分区：
文献类型：
--
作者：
Bahl, Justyna Maria Czarna;Heegaard, Niels H. H.;Christiansen, Michael
实验室标志物在散发性克雅氏病（sCJD）的诊断标准中占有突出地位。在这里，我们研究了蛋白质14-3-3、总tau（t-tau）、苏氨酸-181-磷酸化tau（p-tau）、和神经元特异性烯醇化酶（NSE）以及朊蛋白基因型来区分sCJD患者（n = 21）与神经系统对照（n = 164）和阿尔茨海默病（AD）患者（n = 49）。t-tau比值是sCJD的最佳单一标志物，其对神经系统对照的特异性为90%，敏感性为86%，而NSE的准确性最低，其敏感性为79%，特异性为90%。许多sCJD患者的t-tau值极高，但AD标志物p-tau值正常。蛋白质14-3-3非常敏感（95%），但特异性相对较低（75%）。一个升高的t-tau蛋白浓度与CSF中14-3-3蛋白的存在相结合，得到了最好的测试特异性为96%，84%sensitivity.We的结论是，一个以上的神经变性CSF标志物的组合可以提高sCJD对神经系统控制，包括其他痴呆患者的诊断测试的准确性。(C)2008年爱思唯尔公司All rights reserved.
Laboratory markers have a prominent place among the diagnostic criteria for sporadic Creutzfeldt-Jakob disease (sCJD). Here we investigate the capability of protein 14-3-3, total-tau (t-tau), threonin-181-phosphorylated tau (p-tau), and neuron-specific enolase (NSE) in cerebrospinal fluid (CSF) together with the prion protein gene genotype to discriminate patients with sCJD (n = 21) from neurological controls (n = 164) and Alzheimer's disease (AD) patients (n = 49).Low p-tau/t-tau ratio was the best single marker for sCJD with 90% specificity against neurological controls at 86% sensitivity whilst NSE was the least accurate with 79% sensitivity at 90% specificity. Many of the sCJD patients had extremely elevated t-tau values but normal values of the AD-marker p-tau. Protein 14-3-3 was very sensitive (95%) although the specificity was relatively low (75%). A combination of elevated t-tau concentration with the presence of 14-3-3 protein in CSF gave the best test specificity of 96% at 84% sensitivity.We conclude that the combination of more than one CSF marker for neurodegeneration can improve the diagnostic test accuracy for sCJD against neurological controls including patients with other dementias. (C) 2008 Elsevier Inc. All rights reserved.