Diagnostic performance of a CSF-biomarker panel in autopsy-confirmed dementia
Diagnostic performance of a CSF-biomarker panel in autopsy-confirmed dementia
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DOI：
10.1016/j.neurobiolaging.2007.02.016
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发表时间：
2008-08-01
影响因子：
4.2
通讯作者：
De Deyn, Peter Paul
中科院分区：
文献类型：
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作者：
Engelborghs, Sebastiaan;De Vreese, Karen;De Deyn, Peter Paul
为了确定脑脊液 (CSF) 生物标志物 β-淀粉样肽 (A beta(1-42))、总 tau 蛋白 (T-tau) 和苏氨酸 181 磷酸化 tau (P-tau(181P)) 与临床诊断的诊断性能相比，我们测定了 100 名尸检确诊的痴呆症患者和 100 名对照受试者的 CSF 样本中的生物标志物水平。由于对照组和痴呆组的年龄不匹配，并且鉴于对照组的生物标志物浓度与年龄存在显着相关性，因此计算了年龄校正的生物标志物浓度。通过逻辑回归构建新模型。使用所有生物标志物，可以将痴呆症与对照组区分开来（敏感性 (S) = 86%，特异性 (Sp) = 89%）。 T-tau 和 A beta(1-42) 能够最佳地区分阿尔茨海默病 (AD) 与其他痴呆症 (NONAD) 和对照（S = 90%，Sp = 89%）。使用 P-tau(181P) 和 A beta(1-42)（S = 80%，Sp = 93%）可以最佳地区分 AD 和 NONAD。后一种模型的诊断准确性 (82.7%) 与基于整个临床检查（包括成像）的临床诊断准确性 (81.6%) 相当。使用该模型，在临床上诊断可疑的病例中，4/6 尸检确诊的 AD 病例和 3/3 尸检确诊的 NONAD 病例可以得到正确的诊断。以病理诊断为参考，显示生物标志物在痴呆鉴别诊断中的价值。新模型已经开发出来，灵敏度、特异性和诊断准确度始终超过 80%。 (c) 2007 Elsevier Inc. 保留所有权利。
To establish diagnostic performance of the cerebrospinal fluid (CSF) biomarkers beta-amyloid peptide (A beta(1-42)), total tau-protein (T-tau) and tau phosphorylated at threonine 181 (P-tau(181P)) compared to clinical diagnosis, biomarker levels were determined in CSF samples from 100 autopsy-confirmed dementia and 100 control subjects. As the control and dementia groups were not age-matched and given the significant associations of biomarker concentrations with age in controls, age-corrected biomarker concentrations were calculated. New models were constructed by means of logistic regression. Using all biomarkers, dementia could be discriminated from controls (sensitivity (S) = 86%, specificity (Sp) = 89%). T-tau and A beta(1-42) optimally discriminated Alzheimer's disease (AD) from other dementias (NONAD) and controls (S = 90%, Sp = 89%). AD was optimally discriminated from NONAD using P-tau(181P) and A beta(1-42) (S = 80%, Sp = 93%). Diagnostic accuracy of the latter model (82.7%) was comparable to clinical diagnostic accuracy (81.6%) that was based on a whole clinical work-up (including imaging). Using this model, in cases with clinically doubtful diagnoses, a correct diagnosis would have been established in 4/6 autopsy-confirmed AD and 3/3 autopsy-confirmed NONAD cases. The value of biomarkers in differential dementia diagnosis was shown, using pathological diagnosis as a reference. New models have been developed, achieving sensitivity, specificity and diagnostic accuracy levels, consistently exceeding 80%. (c) 2007 Elsevier Inc. All rights reserved.