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CSF neopterin level as a diagnostic marker in primary central nervous system lymphoma

Viaccoz, Aurélien ; Ducray, François ; Tholance, Yannick ; Barcelos, Gleicy Keli ; Thomas-Maisonneuve, Laure ; Ghesquières, Hervé ; Meyronet, David ; Quadrio, Isabelle ; Cartalat-Carel, Stéphanie ; Louis-Tisserand, Guy ; Jouanneau, Emmanuel ; Guyotat, Jacques ; Honnorat, Jérôme ; Perret-Liaudet, Armand

In: Neuro-Oncology, 2015, vol. 17, no. 11, p. 1497-1503

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    Title
    • CSF neopterin level as a diagnostic marker in primary central nervous system lymphoma
    Author
    • Viaccoz, Aurélien. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Ducray, François. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Tholance, Yannick. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Barcelos, Gleicy Keli. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Thomas-Maisonneuve, Laure. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Ghesquières, Hervé. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Meyronet, David. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Quadrio, Isabelle. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Cartalat-Carel, Stéphanie. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Louis-Tisserand, Guy. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Jouanneau, Emmanuel. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Guyotat, Jacques. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Honnorat, Jérôme. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    • Perret-Liaudet, Armand. Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncology Department, Bron, Lyon, Université Claude-Bernard Lyon 1, Lyon, Neurochemistry Unit, Biochemistry Department, Bron, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Hematology Department, Lyon, Neuroradiology Department, Bron, Neurosurgery Department B, Bron, Neurosurgery Department D, Bron, France, France, France, France, Switzerland, France, France, France, France
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Neuro-Oncology, 2015, vol. 17, no. 11, p. 1497-1503. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:297878
    Summary
    Background The diagnosis of primary central nervous system lymphoma (PCNSL) can be challenging. PCNSL lesions are frequently located deep within the brain, and performing a cerebral biopsy is not always feasible. The aim of this study was to investigate the diagnostic value of CSF neopterin, a marker of neuroinflammation, in immunocompetent patients with suspected PCNSL. Methods We retrospectively reviewed the characteristics of 124 patients with brain tumor (n = 82) or an inflammatory CNS disorder (n = 42) in whom CSF neopterin levels were assessed. Twenty-eight patients had PCNSL, 54 patients had another type of brain tumor (glioma n = 36, metastasis n = 13, other n = 5), and 13 patients had a pseudotumoral inflammatory brain lesion. Results CSF neopterin levels were significantly higher in the patients with PCNSL than in those with other brain tumors (41.8 vs 5.1 nmol/L, P < .001), those with pseudotumoral inflammatory brain lesions (41.8 vs 4.3 nmol/L, P < .001), and those with nontumefactive inflammatory CNS disorders (41.8 vs 3.8 nmol/L, P < .001). In the 95 patients with space-occupying brain lesions, at a cutoff of 10 nmol/L, the sensitivity of this approach was 96% and the specificity was 93% for the diagnosis of PCNSL. The positive and negative predictive values were 84% and 98%, respectively. Conclusion Assessing CSF neopterin levels in patients with a suspected brain tumor might be helpful for the positive and differential diagnosis of PCNSL. A prospective study is warranted to confirm these results