European Journal of Pediatrics

, Volume 148, Issue 1, pp 3–8 | Cite as

Malignancy markers in the cerebrospinal fluid

  • M. Koskiniemi
Review

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.

Key words

Brain tumour CSF Leukaemia Marker 

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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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • M. Koskiniemi
    • 1
  1. 1.Childrens' Hospital and Department of VirologyUniversity of HelsinkiHelsinkiFinland

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