生物标志物 生物标志物
Pablo Martinez-Lage1, Eino Solje2,3, Julian G Martins4
1Center for Research and Memory Clinic, CITA-Alzheimer Foundation, San Sebastián, Gipuzkoa, Spain.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 24, 2025
概括
脑脊液中tau与粉样β 42 (pTau/Aβ42) 的比率在诊断阿尔茨海默病 (AD) 时比其他比率更准确. 这一发现表明pTau/Aβ42可能是确认AD诊断的首选生物标志物.
科学领域:
- 神经学 神经学
- 生物标志物发现发现
- 诊断的准确性 诊断的准确性
背景情况:
- 粉样PET是阿尔茨海默病 (AD) 诊断的黄金标准,但成本昂贵,可用性有限.
- 大脑脊髓液 (CSF) 生物标志物比率提供了一个具有成本效益的替代方案,与粉样蛋白PET具有很高的一致性.
- 不同的CSF生物标志物比率与粉样蛋白PET的比较诊断准确性仍然不清楚.
研究的目的:
- 进行诊断测试准确性 (DTA) 的元分析,比较三种CSF生物标志物比率 (Aβ42/Aβ40,pTau/Aβ42和tTau/Aβ42) 与粉样蛋白PET的一致性.
- 为了确定pTau/Aβ42或tTau/Aβ42比率是否与广泛研究的Aβ42/Aβ40比率相比,提供了更好的一致性.
主要方法:
- 通过Medline和Embase的系统文献搜索 (2008年1月 - 2024年10月) 寻找报告CSF生物标志物比率和粉样蛋白PET一致性的研究.
- 使用双变量模型进行诊断测试准确度元分析,包括总结接收器操作特征 (SROC) 曲线,SROC曲线下的面积 (AUC) 值和元回归.
- 使用Reitsma双变模型与R包 mada v0.5.11.11进行的统计分析.
主要成果:
- 包括31项涉及6,238名患者的研究;大多数是前性观察性研究.
- 所有三种CSF比率都显示出与粉样蛋白PET相比,对AD诊断的高灵敏度和特异性.
- 与Aβ42/Aβ40 (AUC 0.944) 和tTau/Aβ42 (AUC 0.948) 相比,pTau/Aβ42比率显示出显著更高的SROC AUC (0.960) 和较低的假阳性率.
结论:
- 所有评估的CSF生物标志物比率都与用于AD诊断的粉样蛋白PET高度一致.
- 与Aβ42/Aβ40和tTau/Aβ42.2相比,pTau/Aβ42比率显示出与粉样蛋白PET阳性度的优异一致性.
- 建议pTau/Aβ42作为确认阿尔茨海默病诊断的首选CSF生物标志物比率.
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