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Intrathecal IgM synthesis as a diagnostic marker in patients with suspected CNS lymphoma

For CNS lymphomas (CNSL), there is a high need for minimally invasive and easily obtainable diagnostic markers. Intrathecal IgM synthesis can easily be determined in routine CSF diagnostics. The aim of this study was to systematically investigate the diagnostic potential of intrathecal IgM synthesis...

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Main Authors: Reinecke, Raphael (Author) , Jahnke, Kolja (Author) , Foltyn-Dumitru, Martha (Author) , Lachner, Karsten (Author) , Armbrust, Moritz (Author) , Weber, Katharina J. (Author) , Zeiner, Pia S. (Author) , Czabanka, Marcus (Author) , Brunnberg, Uta (Author) , Hartmann, Sylvia (Author) , Steinbach, Joachim P. (Author) , Ronellenfitsch, Michael W. (Author)
Format: Article (Journal)
Language:English
Published: June 2024
In: Journal of neurochemistry
Year: 2024, Volume: 168, Issue: 6, Pages: 1157-1167
ISSN:1471-4159
DOI:10.1111/jnc.16069
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1111/jnc.16069
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/jnc.16069
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Author Notes:Raphael Reinecke, Kolja Jahnke, Martha Foltyn-Dumitru, Karsten Lachner, Moritz Armbrust, Katharina J. Weber, Pia S. Zeiner, Marcus Czabanka, Uta Brunnberg, Sylvia Hartmann, Joachim P. Steinbach, Michael W. Ronellenfitsch
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Summary:For CNS lymphomas (CNSL), there is a high need for minimally invasive and easily obtainable diagnostic markers. Intrathecal IgM synthesis can easily be determined in routine CSF diagnostics. The aim of this study was to systematically investigate the diagnostic potential of intrathecal IgM synthesis in primary and secondary CNSL (PCNSL and SCNSL). In this retrospective study, patients with a biopsy-proven diagnosis of PCNSL or SCNSL were compared with patients with other neurological diseases in whom CNSL was initially the primary radiological differential diagnosis based on MRI. Sensitivity and specificity of intrathecal IgM synthesis were calculated using receiver operating characteristic curves. Seventy patients with CNSL were included (49 PCNSL and 21 SCNSL) and compared to 70 control patients. The sensitivity and specificity for the diagnosis of CNSL were 49% and 87%, respectively, for the entire patient population and 66% and 91% after selection for cases with tumor access to the CSF system and isolated intrathecal IgM synthesis. In cases with MRI-based radiological suspicion of CNSL, intrathecal IgM synthesis has good specificity but limited sensitivity. Because of its low-threshold availability, analysis of intrathecal IgM synthesis has the potential to lead to higher diagnostic accuracy, especially in resource-limited settings, and deserves further study.
Item Description:Zuerst veröffentlicht: 08. Februar 2024
Gesehen am 18.06.2024
Physical Description:Online Resource
ISSN:1471-4159
DOI:10.1111/jnc.16069

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