title: Antithrombin III is probably not a suitable biomarker for diagnosis of primary central nervous system lymphoma.
abstract: Antithrombin III (AT III) in cerebrospinal fluid (CSF) has been suggested to have high specificity and sensitivity in separating primary central nervous system (CNS) lymphoma from other neurological conditions. We measured with ELISA CSF and serum AT III and albumin levels in 12 lymphoma patients with CNS involvement, 30 lymphoma patients without CNS involvement, and 41 patients with non-neoplastic neurological diseases. AT III immunostaining was also carried out, in lymphoma patients. Both CSF AT III and albumin levels were higher in lymphoma patients with CNS involvement. AT III/albumin ratio in CSF was the most sensitive and specific measure for diagnosis. Lowest it was in patients with known CNS lymphoma. Serum AT III levels were lower both in CNS lymphoma and systemic lymphoma. CSF AT III levels were shown to be higher in lymphoma patients with CNS involvement, when AT III/albumin ratios were lower. This was probably a result of lowered serum AT III levels, indicating that high levels of AT III in CSF might reflect only leakage of the blood-brain barrier. Thus, AT III fails to be a specific marker for diagnosis of lymphoma CNS involvement.
authors.affiliation: Department of Oncology and Radiotherapy, University of Oulu, Medical Research Center, and Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland, milla.kuusisto@student.oulu.fi.
authors.forename: Milla Elvi Linnea
authors.initials: ME
authors.lastname: Kuusisto
authors.forename: Kirsi-Maria
authors.initials: KM
authors.lastname: Haapasaari
authors.forename: Anne Marja
authors.initials: AM
authors.lastname: Remes
authors.forename: Risto
authors.initials: R
authors.lastname: Bloigu
authors.forename: Peeter
authors.initials: P
authors.lastname: Karihtala
authors.forename: Taina
authors.initials: T
authors.lastname: Turpeenniemi-Hujanen
authors.forename: Outi
authors.initials: O
authors.lastname: Kuittinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000134:cerebrospinal fluid* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D016543:Central Nervous System Neoplasms / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000990:Antithrombin III