Measurements of CSF biochemical tumor markers in patients with meningeal carcinomatosis
Nakagawa, H.; Kubo, S.; Murasawa, A.; Nakajima, S.; Nakajima, Y.; Izumoto, S.; Hayakawa, T.
No Shinkei Geka. Neurological Surgery 19(12): 1135-1141
1991
ISSN/ISBN: 0301-2603 PMID: 1766538 Document Number: 373547
CSF .beta.-glucuronidase, polyamines and carcinoembryonic antigen (CEA) were analyzed in 16 patients with meningeal carcinomatosis from solid tumoris in systemic organs, 27 with benign brain lesions, 11 with primary brain tumors, 14 with metastatic brain tumors and 5 with leptomeningeal dissemination of other malignant diseases. .beta.-glucuronidase levels in all cases of meningeal carcinomatosis, meningeal gliomatosis and meningeal lymphoma were higher than 100 .mu.g/dl/hr. On the other hand, levels in all cases of benign brain lesions were below 100 .mu.g/dl.hr. Levels of .beta.- glucuronidase in the cases of metastatic brian tumors returned to normal lecels after tumor resection. Levels of .beta.-glucuronidase and polyamines were not high in the cases with positive cytology in CSF after tumor resection. The polyamine level seemed to be dependent on the growth rate of the disease and was shown to be below 0.05 nmol/ml in all cases after resection of the metastatic brain tumors. Cystic fluid of both benign and malignant tumor showed high levels of .beta.-glucuronidase and polyamines except for spermidine and spermine levels in a suprasellar cyst. Some case of meningeal carcinomatosis with high levels of serum CFA did not always show high levles of CSF CEA. In the surgical cases with a metastatic brain, tumor, the cases with leptomeningeal, especially dural attachment showed high levels of .beta.-glucuronidase and CEA preoperatively, but they returned to normal after surgery. In 2 cases of meningeal carcinomatosis treated by intrathecal chemotherapy with MTX and Ara-C, CSF .beta.-glucuronidase and CEA showed clinical condition better than the cell count in CSF decreased rapidly following chemotherapy. .beta.-glucuronidase was considered to be a useful CSF marker in the cases of meningeal carcinomastosis to monitor the course of the disease, and CEA was also considered to be useful marker when CEA levels in CSF are higher than those in serum.