-Several markers have been studied for their ability to make the CNS infiltration diagnosis earlier and more precise; previous studies showed that CSF ferritin concentrations were higher in patients with malignant invasion of CNS. The objective was to determine the importance of CSF ferritin as a biomarker for the diagnosis of CNS neoplasic infiltration. This study is based on 93 CSF samples, divided into five groups: malignant cells present (n13); malignant cells not present (n26); inflammatory neurological diseases (n16); neurocysticercosis (n20); acute bacterial meningitis (n18). CSF ferritin values were determined by micro particle enzyme immunoassay. CSF ferritin level (mean±SD) in the group with neoplasic cells in the CSF was 42.8±49.7 ng /mL, higher than in the other groups (p<0.0001). We conclude that CSF ferritin with the cut off 20 ng/mL could be an adjuvant biomarker to the diagnosis of CNS malignant infiltration.Key WorDS: cerebrospinal fluid, ferritin, central nervous system, malignant cells, CNS neoplasm, CNS tumors, bacterial meningitis. Quantificação de ferritina no líquido cefalorraquidiano como biomarcador para o diagnóstico de infiltração maligna no sncResumo -Diversos marcadores foram estudados com a finalidade de avaliar sua capacidade de diagnosticar a infiltração neoplásica no SNC precocemente e de forma mais precisa. estudos anteriores mostraram que as concentrações de ferritina no LCr eram mais elevadas nos pacientes com infiltração neoplásica no SNC. o objetivo foi determinar a importância da ferritina no LCr como biomarcador para o diagnóstico de infiltração neoplásica no SNC. este estudo é baseado em 93 amostras do LCr, divididas em cinco grupos: células malignas presentes (n13); células malignas ausentes (n26); doenças neurologicas inflamatórias (n16); neurocisticercose (n20); meningites bacterianas agudas (n18). os valores de ferritina no LCr foram determinados por eLISA de microparticulas. o nível de ferritina no LCr (média±desvio padrão) no grupo com células neoplásicas no LCr foi 42,8±49,7 ng/mL, mais elevado do que nos outros grupos (p<0.0001). Concluímos que a ferritina no LCr com cut off de 20 ng/mL pode ser um biomarcador para o diagnóstico de infiltração maligna no SNC.PALAvrAS-ChAve: líquido cefalorraquidiano, sistema nervoso central, células malignas, neoplasias do SNC, tumores do SNC, meningites bacterianas.
The most useful laboratory test for diagnosing neoplastic meningitis infiltration is cerebrospinal fluid (CSF) investigation. Accurate diagnosis is important for diagnostic, therapeutic, and prognostic consequences 1 . Cerebrospinal fluid cytology is mandatory in all cases of known or strongly suspected malignancy. This is particularly true in cases of leukemia and lymphoma, in which the results of CSF cell counts and cytology are important factors in determining and monitoring treatment 2,3,4 .The two main methods of CSF cell concentration are cytocentrifugation and the gravitational facility sedimentation chamber. The literature provides no consensus on the optimal technique 5,6 , since both methods have advantages and disadvantages. The aim of this paper was to compare two different methods of cell concentration, cytosedimentation using a Suta chamber and cytocentrifugation. ABSTRACTObjective: To define how to best handle cerebrospinal fluid (CSF) specimens to obtain the highest positivity rate for the diagnosis of malignancy, comparing two different methods of cell concentration, sedimentation and cytocentrifugation. Methods: A retrospective analysis of 411 CSF reports. Results: This is a descriptive comparative study. The positive identification of malignant CSF cells was higher using the centrifuge than that using the Suta chamber (27.8% vs. 19.0%, respectively; p = 0.038). Centrifuge positively identified higher numbers of malignant cells in samples with a normal concentration of white blood cells (WBCs) (< 5 cells/mm 3 ) and with more than 200 cells/mm 3 , although this was not statistically significant. There was no lymphocyte loss using either method. Conclusions:Cytocentrifugation positively identified a greater number of malignant cells in the CSF than cytosedimentation with the Suta chamber. However, there was no difference between the methods when the WBC counts were within the normal range.Keywords: cerebrospinal fluid; cytology, centrifugation, sedimentation. RESUMOObjetivo: Definir qual a melhor forma de concentrar amostras de LCR para obter maior porcentagem de positividade para o diagnóstico de infiltração neoplásica. comparando dois métodos diferentes de concentração de células, sedimentação e citocentrifugação. Métodos:Análise retrospectiva de 411 laudos de LCR. Resultados: Estudo comparativo descritivo. A identificação de células neoplásicas no LCR foi mais elevada quando usada a citocentrífuga do que a câmara de Suta (28% vs 19,0%, respectivamente; p = 0,038). Centrifugação identificou maior número de células neoplásicas em amostras com concentração de células < 5 células/mm 3 e superior a 200 células/mm 3 , embora não significativo. Não houve perda de linfócitos usando qualquer um dos métodos. Conclusões: A citocentrifugação identificou um número maior de células malignas no LCR do que a sedimentação com a câmara de Suta. No entanto, não houve diferença entre os métodos quando as contagens de leucócitos estavam dentro do intervalo normal.Palavras-chave: líquido cefalorraquidiano; citolog...
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