Predictive values of beta-trace protein (prostaglandin D synthase) by use of laser-nephelometry assay for the identification of cerebrospinal fluid.

Abstract

OBJECTIVE:

beta-Trace protein (beta-TP) is an immunological marker for the detection of cerebrospinal fluid traces. The aim of the study was to evaluate the predictive values of a new research assay for beta-TP.

METHODS:

A total of 154 specimens from patients with otorrhea or rhinorrhea were investigated for cerebrospinal fluid (CSF) by use of a laser-nephelometric assay for beta-TP. Samples were obtained between January 1994 and November 2000. A sample was reported to be positive for CSF when the beta-TP concentration was more than 6 mg/L. Case evaluations were performed retrospectively and tabulated for indication, clinical course, additional investigations, surgical procedure, and follow-up.

RESULTS:

beta-TP was detected in 16 specimens; 138 samples were negative for beta-TP with a value less than 3 mg/L. One sample was suggestive of CSF traces at 4.6 mg/L. In correlation with the clinical course, the intraoperative findings, intraoperative visualization with sodium fluorescein, high-resolution computed tomography of the paranasal sinuses or the petrous bone, computed tomographic cisternography, magnetic resonance imaging, and radionuclide cisternography, there was no false-positive result. On four occasions, false-negative results occurred, with an overall accuracy of 0.974. The beta-TP test had a negative predictive value of 0.971 and a positive predictive value of 1.

CONCLUSION:

Analysis of betas-TP via the nephelometric assay is a valuable and reliable test in cranial base surgery for the identification of CSF.

• Authors: Gregor Bachmann, Hela Petereit, Uta Djenabi, Olaf Michel
• Journal: Neurosurgery (Neurosurgery) Vol. 50 Issue 3 Pg. 571-6; discussion 576-7 (Mar 2002) ISSN: 0148-396X [Print] United States
• PMID: 11841726 (Publication Type: Journal Article)

Chemical References

• Lipocalins
• Intramolecular Oxidoreductases
• prostaglandin R2 D-isomerase
• Glucose

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Cerebrospinal Fluid Otorrhea (cerebrospinal fluid, diagnosis)
• Cerebrospinal Fluid Rhinorrhea (cerebrospinal fluid, diagnosis)
• Child
• Child, Preschool
• False Positive Reactions
• Glucose (cerebrospinal fluid)
• Humans
• Intramolecular Oxidoreductases (cerebrospinal fluid)
• Lasers
• Lipocalins
• Male
• Middle Aged
• Nephelometry and Turbidimetry (methods)
• Predictive Value of Tests
• Retrospective Studies
• Sensitivity and Specificity