title: A comparison of tau and 14-3-3 protein in the diagnosis of Creutzfeldt-Jakob disease.
abstract: OBJECTIVE
  To compare the respective efficiency of CSF tau (quantitative) and CSF 14-3-3 protein (qualitative) in the diagnosis of prion disease.
  
  
  METHODS
  We made measurements on 420 live subjects, who subsequently underwent a postmortem neuropathology examination, including protein chemistry, immunohistochemistry, and histology. We performed tau by ELISA. We detected 14-3-3 protein by Western blot. Both assays were optimized for maximum efficiency (accuracy).
  
  
  RESULTS
  We found tau and 14-3-3 proteins to be closely correlated, but tau had a significantly better ability to predict disease status than 14-3-3 protein. Also, tau distinguished disease status at least as well as when both assays' results are combined in a variety of ways. Importantly, the area under the receiver operating characteristic curve for tau (0.82) was significantly larger than that for 14-3-3 protein (0.68) (p < 0.001). Diagnostic test statistics are provided for the study subjects with 58.3% prevalence, and for a more typical, nonselected, 7.5% prevalence as received by our center.
  
  
  CONCLUSIONS
  In this study, tau is superior to 14-3-3 protein as a marker in the diagnosis of Creutzfeldt-Jakob disease, and is as efficient singly compared to a variety of combinations with 14-3-3 protein. This is the first study of this magnitude to examine prion disease diagnostic tests in a carefully characterized patient population with detailed statistical evaluation.
authors: Department of Pathology, Case Western Reserve University, Cleveland, OH, USA. clive.hamlin@case.edu
authors: Clive
authors: C
authors: Hamlin
authors: Gianfranco
authors: G
authors: Puoti
authors: Sally
authors: S
authors: Berri
authors: Elliott
authors: E
authors: Sting
authors: Carrie
authors: C
authors: Harris
authors: Mark
authors: M
authors: Cohen
authors: Charles
authors: C
authors: Spear
authors: Alberto
authors: A
authors: Bizzi
authors: Sara M
authors: SM
authors: Debanne
authors: Douglas Y
authors: DY
authors: Rowland
mesh_terms: D048948:14-3-3 Proteins / Q000134:cerebrospinal fluid*; D019540:Area Under Curve; D015415:Biomarkers / Q000134:cerebrospinal fluid; D007562:Creutzfeldt-Jakob Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D006801:Humans; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D048948:14-3-3 Proteins; D015415:Biomarkers; D016875:tau Proteins