Diagnostic values of beta-2 transferrin and beta-trace protein as markers for cerebrospinal fluid fistula.
BACKGROUND
During recent decades, beta2-transferrin and beta-trace protein (prostaglandin D synthase) have been used as immunological markers for the diagnosis of CSF fistula. A method for detecting CSF traces should be non invasive, reliable and cheap.


METHODS
The characteristics of the two immunological markers are described based on own experience and a literature review. PubMed (1966-2007) was searched and 39 articles were retrieved from the period 1987-2007.


RESULTS
The beta2-transferrin marker showed a high reliability during the last decades using immunofixation or immunoblotting. The performance of beta2-transferrin assay requires between two and four hours hands-on time in the laboratory depending on the assay. The beta-trace protein protein marker showed a high reliability when assayed using immunoelectrophoresis or laser-nephelometry. Laser-nephelomety is automated, non- time consuming, provides quantitative results and last but not least, is cheap. A cut-off point at 1.11 mg/l for beta-trace protein gave the best trade-off between high sensitivity and high specificity when including the secretion/serum ratio.


CONCLUSIONS
Both beta2-transferrin and beta-trace protein are reliable immunological markers for the detection of CSF traces. High diagnostic accuracy values were found for both beta2-transferrin and beta-trace protein protein.
Rikshospitalet Medical Centre, Oslo, Norway. gregor.bachmann-harildstad@rikshospitalet.no
Gregor
G
Bachmann-Harildstad
D015415:Biomarkers / Q000378:metabolism; D002555:Cerebrospinal Fluid; D005402:Fistula / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000378:metabolism*; D054834:Lipocalins / Q000378:metabolism*; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D014168:Transferrin / Q000378:metabolism*
D015415:Biomarkers; D054834:Lipocalins; D014168:Transferrin; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase