title: Pseudocholinesterase activity in cerebrospinal fluid as a biomarker of solid central nervous system tumors in children.
abstract: OBJECTIVE
  To determine the activity of pseudocholinesterase (PChE) in cerebrospinal fluid (CSF) and serum in children with solid central nervous system (CNS) tumor and to assess whether PChE activity could be a valid biomarker for solid CNS tumors in children.
  
  
  METHODS
  The study and control group included 30 children each. Children in the study group had a solid CNS tumor, while those from the control group had never suffered from any tumor diseases. CSF and serum samples were collected from all participants and PChE activity was determined using the Ellman's spectrophotometric method. PChE activity in CSF was shown as a cerebrospinal fluid/serum ratio expressed in percentage, ie, PChE CSF/serum ratio. Receiver operating characteristic (ROC) curve was used to assess whether PChE activity can be used as a biomarker for identifying children with solid CNS tumors.
  
  
  RESULTS
  Children with solid CNS tumor had significantly higher PChE activity in CSF and serum, as well as PChE CSF/serum ratio (P=0.001). PChE CSF/serum ratio in the study group was 2.38% (interquartile range [IQR] 1.14-3.97) and 1.09% (IQR 0.95-1.45) in the control group. ROC curve analysis of PChE CSF/serum ratio resulted in an area under the curve (AUC) value of 0.76 (95% confidence interval [CI] 0.63-0.88) and a cut-off of 1.09. Twenty five of 29 patients with elevated PChE CSF/serum ratio had a tumor, corresponding to a sensitivity of 83% and a specificity of 53%.
  
  
  CONCLUSIONS
  PChE CSF/serum ratio may be used as a test or biomarker with good sensitivity for solid CNS tumors in children.
authors.affiliation: Lili Mikecin, University Clinical Center Maribor, Pediatric Intensive Care Unit, Ljubljanska ulica 5, 2000 Maribor, Slovenia, mikecin.lili@gmail.com.
authors.forename: Lili
authors.initials: L
authors.lastname: Mikecin
authors.forename: Miljenko
authors.initials: M
authors.lastname: Krizmaric
authors.forename: Jasminka
authors.initials: J
authors.lastname: Stepan Giljevic
authors.forename: Miroslav
authors.initials: M
authors.lastname: Gjurasin
authors.forename: Josipa
authors.initials: J
authors.lastname: Kern
authors.forename: Jasna
authors.initials: J
authors.lastname: Lenicek Krleza
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Popovic
mesh_terms: D000293:Adolescent; D014408:Biomarkers, Tumor / Q000097:blood* / Q000134:cerebrospinal fluid*; D002091:Butyrylcholinesterase / Q000097:blood* / Q000134:cerebrospinal fluid*; D016022:Case-Control Studies; D016543:Central Nervous System Neoplasms / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D002091:Butyrylcholinesterase