Diagnostic values of beta-2 transferrin and beta-trace protein as markers for cerebrospinal fluid fistula
Bachmann-Harildstad, G.
Rhinology 46(2): 82-85
2008
ISSN/ISBN: 0300-0729 PMID: 18575006 Document Number: 620170
Introduction: During recent decades, beta(2)-transferrin and beta-trace protein (prostaglandin D synthase) have been used as immunological markers for the diagnosis of CSF fistula. A method for detecting CSF traces should be non invasive, reliable and cheap.Methods: The characteristics of the two immunological markers are described based on own experience and a literature review. PubMed (1966 - 2007) was searched and 39 articles were retrieved from the period 1987 - 2007.Results: The beta(2)-transferrin marker showed a high reliability during the last decades using immunofixation or immunoblotting. The performance of beta(2)-transferrin assay requires between two and four hours hands-on time in the laboratory depending on the assay. The beta-trace protein protein marker showed a high reliability when assayed using immunoelectrophoresis or laser-nephelometry. Laser-nephelomety is automated, non- time consuming, provides quantitative results and last but not least, is cheap. A cut-off point at 1.11 mg/l for beta-trace protein gave the best trade-off between high sensitivity and high specificity when including the secretion/serum ratio.Conclusion: Both beta(2)-transferrin and beta-trace protein are reliable immunological markers for the detection of CSF traces. High diagnostic accuracy values were found for both beta(2)-transferrin and beta-trace protein protein.