生物标志物 生物标志物
Manizhe Eslami-Amirabadi1,2,3, Tara N Ellingson4, Melanie Stephens4
1University of California, San Francisco, San Francisco, CA, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 26, 2025
概括
粉样蛋白PET扫描可以提高痴呆症诊断的准确性. 然而,负面扫描显示了对LATE和脑血管疾病等疾病的更好的生物标志物的需求,特别是在75岁以上的患者中.
科学领域:
- 神经学 神经学
- 医疗成像医学成像
- 老年病的医生 老年病的医生
背景情况:
- 与病理确认相比,阿尔茨海默病 (AD) 的临床诊断存在局限性.
- 粉样蛋白PET成像不侵入性检测粉样蛋白斑块,一个关键的AD生物标志物,提高诊断准确度和临床决策.
- 粉胺PET的医疗保险覆盖率增加,导致其在痴呆患者护理中得到更广泛的利用.
研究的目的:
- 在现实世界痴呆症诊断环境中审查粉样蛋白PET扫描的利用.
- 分析粉胺PET对痴呆症患者差异诊断的影响.
- 了解负粉样蛋白PET扫描的诊断影响.
主要方法:
- 记忆和衰老中心1708名患者遭遇的回顾性图表审查 (2023年7月至2024年7月).
- 包括547名患有痴呆症生物标志物测试订单 (PET和液体生物标志物) 的独特患者的920次接触.
- 对接受粉样蛋白PET治疗的患者的评估差异诊断和成像发现,与其他痴呆症综合征的诊断标准进行比较.
主要成果:
- 在43%的遭遇中订购了amyloid PET,但在24%的订购中没有执行.
- 接受粉样蛋白PET治疗的患者中有24%的扫描结果为阴性.
- 阴性PET扫描的诊断包括边缘主导性与年龄相关的TDP蛋白质病变 (LATE),脑血管疾病,勒维体病,4R形病变和功能/精神疾病,通常有多种促成因素,特别是在75岁以上的患者中.
结论:
- 粉样蛋白PET对于识别符合粉样蛋白向治疗的患者至关重要,但负面结果会导致诊断不确定性,特别是在非专业的环境中.
- 伦理方面的考虑来自于在没有粉样蛋白病理的患者中诊断的不确定性.
- 为替代性神经病理诊断开发可靠的生物标志物对于减少不确定性和改善对非阿尔茨海默氏症痴呆症的护理至关重要.
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