[Frontiers in Bioscience E3, 1259-1264, June 1, 2011]

Optimal cut-off values for tumor markers in cerebrospinal fluid with ROC curve analysis

Qiang Shi1, Chuan Qiang Pu1, Xu Sheng Huang1, Cheng Lin Tian1, Xiu Tang Cao2

1Department of Neurology, General Hospital of PLA, Beijing 100853, China, 2 Department of medical statistics, General Hospital of PLA, Beijing 100853, China

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Materials and Methods
3.1. Clinical data
3.1.1. Introduction of 21 MC patients
3.1.2. Introduction of 25 cancer patients without leptomeningeal disease
3.1.3. Introduction of 45 meningitis patients
3.2. Sampling
3.3. Concentration determinations
3.4. Statistical analyses
4. Results
4.1. Data consistency check among three groups
4.2. Comparison of tumor markers in CSF and serum among three groups
4.2.1. Comparison of tumor markers in CSF among three groups
4.2.2. Comparison of tumor markers in serum among three groups
4.3. MC patients compared with group one through ROC curve
4.3.1. Area under the curve with ROC curve analysis
4.3.2. Optimal cut-off values for tumor markers in CSF
4.4. MC patients compared with group two through ROC curve
4.4.1. Area under the curve with ROC curve analysis
4.4.2. Optimal cut-off values for tumor markers in CSF
5. Discussion
6. References

1. ABSTRACT

To select optimal cut-off values of tumor markers in cerebrospinal fluid for the diagnosis of meningeal carcinomatosis, the concentrations of CEA, CA125, CA153, CA199, CA724, CYFRA21-1, AFP and NSE were determined by means of double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) in 21 MC patients, 25 cancer patients without leptomeningeal disease (group one) and 45 meningitis patients (group two) using the Roche E170 modular immunoassay analyzer. Optimal cut-off values were selected based on a receiver-operating characteristic curve. The results showed that CA125 and CEA in CSF were optimal diagnostic indices distinguishing between MC patients and cancer patients without leptomeningeal disease. Cut-off values for CA125 and CEA were 1.715 microlilters and 0.274 microgram/l, respectively. In addition, CEA in CSF was the optimal diagnostic index distinguishing MC patients from meningitis patients. The cut-off value for CEA was 4.522 microgram/l.