Osteopontin in cerebrospinal fluid as diagnostic biomarker for central nervous system lymphoma.
Central nervous system lymphoma (CNSL) is diagnostically challenging. The identification of reliable and easy to measure biomarkers is desirable to facilitate diagnosis. Here, we evaluated the value of cerebrospinal fluid (CSF) osteopontin (OPN) as a diagnostic biomarker for CNSL. OPN concentrations in CSF from 37 patients with CNSL (29 with primary CNSL and 8 with secondary CNS involvement of systemic lymphoma) and 36 controls [6 patients with inflammatory CNS disease other than multiple sclerosis (MS), 8 with MS, 9 with glioblastoma (GBM) and 13 healthy controls] were determined using an enzyme-linked immunosorbent assay. Non-parametric tests and receiver operating characteristic (ROC) curves were performed for determination of diagnostic accuracy. Median CSF OPN level in all CNSL patients was 620 ng/mL and higher than in patients with inflammatory CNS disease (356 ng/mL); P < .05, MS (163 ng/mL); P < .01, GBM (41 ng/mL); P < .01, or healthy controls (319 ng/mL); P < .01. The area under the ROC curve was 0.865 [95 % confidence interval (CI) 0.745-0.985] for differentiating CNSL and patients with inflammatory CNS disease; 0.956 (95 % CI 0.898-1.000) for CNSL and MS patients; 0.988 (95 % CI 0.964-1.000) for CNSL and GBM patients, and 0.915 (95 % CI 0.834-0.996) for CNSL patients and healthy controls. In multivariate analysis, high CSF OPN level was associated with shorter progression-free (HR 1.61, 95 % CI 1.13-2.31; P = .009) and overall survival (HR 1.52, 95 % CI 1.04-2.21; P = .029). CSF OPN is a potential biomarker in CNSL.
Department of Hematology, Oncology and Tumour Immunology, Charité University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
Felicitas
F
Strehlow
Department of Medical Immunology, Charité University Medicine Berlin, Berlin, Germany.
Sandra
S
Bauer
Institute of Clinical Epidemiology and Applied Biostatistics, University Tuebingen, Tuebingen, Germany.
Peter
P
Martus
Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Michael
M
Weller
Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Patrick
P
Roth
Department of Neurology, Knappschaftskrankenhaus, University Hospital Bochum, Bochum, Germany.
Uwe
U
Schlegel
Department of Neurology, Knappschaftskrankenhaus, University Hospital Bochum, Bochum, Germany.
Sabine
S
Seidel
Department of Medical Immunology, Charité University Medicine Berlin, Berlin, Germany.
Carmen
C
Scheibenbogen
Department of Hematology, Oncology and Tumour Immunology, Charité University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
Agnieszka
A
Korfel
Department of Hematology, Oncology and Tumour Immunology, Charité University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. stephan.kreher@charite.de.
Stephan
0000-0002-8948-8297
S
Kreher
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid*; D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D053495:Osteopontin / Q000134:cerebrospinal fluid*; D012372:ROC Curve
D014408:Biomarkers, Tumor; C506895:SPP1 protein, human; D053495:Osteopontin
Cerebrospinal fluid; Osteopontin; PCNSL; SCNSL