Quantification of cerebrospinal fluid ferritin as a biomarker for CNS malignant infiltration

Abstract

-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.

Diagnosis and individualized therapy of neoplastic meningitis

“…Ferritin is a marker with low specificity, but moderately good sensitivity for neoplastic changes, which can also reach a value above 18 µg/l after bleeding or during infection [35]. In agreement with the literature, we found elevated ferritin in 50% of patients with NM and, of particular note, did not find pathological levels in a control group of 24 patients [33].…”

Human ferritin for tumor detection and therapy

“…Besides serum levels, secretory ferritin levels in CSF are also found to increase during malignant infiltration of the central nervous system, and CSF ferritin has been studied for its ability to serve as a biomarker for the diagnosis of brain malignancies . Intriguingly, exhaled ferritin has been reported as potential biomarker for lung cancer …”

Measurement of ferritin and anti‐ferritin autoantibodies in serum and colostrum of Holstein and Japanese Black cows

“…; De Almeida et al . ; Orino & Watanabe ). Serum ferritin levels are positively correlated with body iron reserves in animals, including humans (Walters et al .…”

“…Ferritin is present in blood circulation at relatively low concentrations (< 1 mg/mL) (Addison et al 1972;Smith et al 1984a,b;Miyata & Furugouri 1987;Andrews et al 1992bAndrews et al , 1994 and is also found in other extracellular fluids, such as milk and synovial and cerebrospinal fluids Orino et al 2006a;De Almeida et al 2008;Orino & Watanabe 2008). Serum ferritin levels are positively correlated with body iron reserves in animals, including humans (Walters et al 1973;Smith et al 1984a,b;Miyata & Furugouri 1987;Andrews et al 1992bAndrews et al , 1994.…”