Pseudocholinesterase activity in cerebrospinal fluid as a biomarker of solid central nervous system tumors in
Lili Mikecin1, Miljenko Krizmaric, Jasminka Stepan Giljevic
1Lili Mikecin, University Clinical Center Maribor, Pediatric Intensive Care Unit, Ljubljanska ulica 5, 2000 Maribor, Slovenia, mikecin.lili@gmail.com.
Insights
Pseudocholinesterase (PChE) activity in cerebrospinal fluid (CSF) and serum is elevated in children with solid central nervous system (CNS) tumors. The PChE CSF/serum ratio shows potential as a sensitive biomarker for pediatric CNS tumors.
Area of Science:
- Biochemistry
- Pediatric Oncology
- Neurology
Background:
- Solid central nervous system (CNS) tumors are a significant health concern in children.
- Identifying reliable biomarkers for early diagnosis and monitoring of pediatric CNS tumors is crucial.
- Pseudocholinesterase (PChE) is an enzyme with potential diagnostic applications.
Purpose of the Study:
- To measure pseudocholinesterase (PChE) activity in cerebrospinal fluid (CSF) and serum of children diagnosed with solid CNS tumors.
- To evaluate the PChE cerebrospinal fluid/serum ratio as a potential biomarker for solid CNS tumors in pediatric patients.
- To assess the diagnostic accuracy of the PChE CSF/serum ratio using receiver operating characteristic (ROC) curve analysis.
Main Methods:
- A comparative study involving 30 children with solid CNS tumors and 30 healthy controls.
- Collection of cerebrospinal fluid (CSF) and serum samples from all participants.
- Determination of PChE activity using Ellman's spectrophotometric method and calculation of the PChE CSF/serum ratio.
- ROC curve analysis to determine the sensitivity and specificity of the PChE CSF/serum ratio as a biomarker.
Main Results:
- Children with solid CNS tumors exhibited significantly higher PChE activity in both CSF and serum compared to controls (P=0.001).
- The PChE CSF/serum ratio was notably higher in the study group (2.38%) versus the control group (1.09%).
- ROC analysis yielded an area under the curve (AUC) of 0.76, with a sensitivity of 83% and specificity of 53% at a cut-off of 1.09.
Conclusions:
- The PChE CSF/serum ratio demonstrates potential as a valuable biomarker for detecting solid CNS tumors in children.
- This ratio offers good sensitivity, suggesting its utility as a screening or diagnostic test.
- Further research may validate the PChE CSF/serum ratio for clinical application in pediatric neuro-oncology.
Aim:
To determine the activity of pseudocholinesterase (PChE) in cerebrospinal fluid (CSF) and serum in children with solid central nervous system (CNS) tumor and to assess whether PChE activity could be a valid biomarker for solid CNS tumors in children.
Methods:
The study and control group included 30 children each. Children in the study group had a solid CNS tumor, while those from the control group had never suffered from any tumor diseases. CSF and serum samples were collected from all participants and PChE activity was determined using the Ellman's spectrophotometric method. PChE activity in CSF was shown as a cerebrospinal fluid/serum ratio expressed in percentage, ie, PChE CSF/serum ratio. Receiver operating characteristic (ROC) curve was used to assess whether PChE activity can be used as a biomarker for identifying children with solid CNS tumors.
Results:
Children with solid CNS tumor had significantly higher PChE activity in CSF and serum, as well as PChE CSF/serum ratio (P=0.001). PChE CSF/serum ratio in the study group was 2.38% (interquartile range [IQR] 1.14-3.97) and 1.09% (IQR 0.95-1.45) in the control group. ROC curve analysis of PChE CSF/serum ratio resulted in an area under the curve (AUC) value of 0.76 (95% confidence interval [CI] 0.63-0.88) and a cut-off of 1.09. Twenty five of 29 patients with elevated PChE CSF/serum ratio had a tumor, corresponding to a sensitivity of 83% and a specificity of 53%.
Conclusion:
PChE CSF/serum ratio may be used as a test or biomarker with good sensitivity for solid CNS tumors in children.
