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논문 기본 정보

자료유형
학술저널
저자정보
Shim, Youngbo (Department of Neurosurgery, Seoul National University College of Medicine) Gwak, Ho-Shin (Department of System Cancer Science, Graduate School of Cancer Science and Policy, National Cancer Center) Kim, Sohee (Cancer Biostatistics Branch, National Cancer Center) Joo, Jungnam (Cancer Biostatistics Branch, National Cancer Center) Shin, Sang-Hoon (Neuro-Oncology Clinic, National Cancer Center) Yoo, Heon (Neuro-Oncology Clinic, National Cancer Center)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제59권 제6호
발행연도
2016.1
수록면
570 - 576 (7page)

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Objective : Elevated cell counts and protein levels in cerebrospinal fluid (CSF) result from disease activity in patients with leptomeningeal carcinomatosis (LMC). Previous studies evaluated the use of CSF profiles to monitor a treatment response or predict prognosis. CSF profiles vary, however, according to the sampling site and the patient's systemic condition. We compared lumbar and ventricular CSF profiles collected before intraventricular chemotherapy for LMC and evaluated the association of these profiles with patients' systemic factors and LMC disease activity. Methods : CSF profiles were retrospectively collected from 228 patients who underwent Ommaya reservoir insertion for intraventricular chemotherapy after a diagnosis of LMC. Lumbar samples taken via lumbar puncture were used for the diagnosis, and ventricular samples were obtained later at the time of Ommaya reservoir insertion. LMC disease activity was defined as the presence of LMC-related symptoms such as increased intracranial pressure, hydrocephalus, cranial neuropathy, and cauda equina syndrome. Results : Cell counts (median : 8 vs. 1 cells/mL) and protein levels (median : 68 vs. 17 mg/dL) significantly higher in lumbar CSF than in ventricular CSF (p<0.001). Among the evaluated systemic factors, concomitant brain metastasis and previous radiation were significantly correlated with higher protein levels in the lumbar CSF (p=0.01 and <0.001, respectively). Among the LMC disease activity, patients presenting with hydrocephalus or cauda equina syndrome showed higher lumbar CSF protein level compared with that in patients without those symptoms (p=0.049 and p<0.001, respectively). The lumbar CSF cell count was significantly lower in patients with cranial neuropathy (p=0.046). The ventricular CSF cell counts and protein levels showed no correlation with LMC symptoms. Carcinoembryonic antigen (CEA), which was measured from ventricular CSF after the diagnosis in 109 patients, showed a significant association with the presence of hydrocephalus (p=0.01). Conclusion : The protein level in lumbar CSF indicated the localized disease activity of hydrocephalus and cauda equina syndrome. In the ventricular CSF, only the CEA level reflected the presence of hydrocephalus. We suggest using more specific biomarkers for the evaluation of ventricular CSF to monitor disease activity and treatment response.
#Cerebrospinal fluid #Leptomeningeal carcinomatosis #Lumbar #Ventricular

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참고문헌 (26)

참고문헌 신청
An YJ / 2015 / An NMR metabolomics approach for the diagnosis of leptomeningeal carcinomatosis in lung adenocarcinoma cancer patients / Int J Cancer 136:162~171 google schola Balm M / 1996 / Leptomeningeal carcinomatosis. Presenting features and prognostic factors / Arch Neurol 53:626~632 google schola Boogerd W / 1991 / Meningeal carcinomatosis in breast cancer. Prognostic factors and influence of treatment / Cancer 67:1685~1695 google schola Bruna J / 2009 / Neuro-Oncology Unit of the Institute of Biomedical Investigation of Bellvitge : Leptomeningeal carcinomatosis : prognostic implications of clinical and cerebrospinal fluid features / Cancer 115:381~389 google schola Chamberlain MC / 2010 / Leptomeningeal metastasis / Curr Opin Oncol 22:627~635 google schola

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