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Malignancy markers in the cerebrospinal fluid

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Abstract

The specificity and sensitivity of malignancy marker determinations in cerebrospinal fluid (CSF) are often insufficient. Even at the subclinical stage of the disease the marker should be present. The effect of therapy should be monitored and relapses noted. Thus high standards of methodology are required. There are many substances that may indicate a malignant process in the central nervous system. However, there are many pitfalls in their determination. Malignant cells may occur in CSF via processes involving leptomeningeal structures such as metastases and leukaemia, but primary brain tumours seldom show cells in CSF. Human chorionic gonadotrophin and alpha-fetoprotein determinations assist in the early detection of cerebral germ cell tumours and of relapses, even in the subclinical stage. Desmosterol may aid in the diagnosis of medulloblastomas and malignant gliomas and in monitoring therapy. Putrescine levels are elevated in CSF of patients with medulloblastoma and correlate with the clinical state, and serial analyses may reveal relapses. Fibronectin, when determined in CSF at the time of diagnosis, appears to be of great significance for the prognosis of acute lymphoblastic leukaemia. Ferritin and beta-2-microglobulin may help in some well-defined conditions. Brain-specific proteins and antibodies to them are non-specific markers whereas tumour-specific antigens and growth factors may be more significant.

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Abbreviations

AAT:

alpha-1-antitrypsin

AFP:

alpha fetoprotein

ALL:

acute lymphoblastic leukaemia

ASAT:

aspartate aminotransferase

B-2-m:

peta-2-microglobulin

CEA:

carcinoembryonic protein

CK:

creatine kinase

CNS:

central nervous system

CSF:

cerebrospinal fluid

FN:

fibronectin

GFAP:

glial fibrillary acidic protein

HCG:

human chorionic gonadotrophin

LD:

lactate dehydrogenase

MBP:

myelin basic protein

NGF:

nerve growth factor

NSE:

neuronespecific enolase

PA:

plasminogen activator

PG:

prostaglandin

TdT:

terminal deoxynucleotidyl transferase

TX:

thromboxane

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Koskiniemi, M. Malignancy markers in the cerebrospinal fluid. Eur J Pediatr 148, 3–8 (1988). https://doi.org/10.1007/BF00441801

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Key words

  • Brain tumour
  • CSF
  • Leukaemia
  • Marker