Chemical Markers in Spinal Fluid for Tumours of the Central Nervous System (CNS)

Kaye, Stanley B.; Bagshawe, K. D.

doi:10.1007/978-1-349-04285-2_29

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…(Laterre et al, 1964) and these include an oc-globulin fraction with the biochemical properties of glycoprotein similar to those of AFP. There is therefore a possibility of cross-reactivity with a normal CSF constituent in the AFP assay, and results from a preliminary study on CSF specimens from patients with non-malignant neurological disease lend support to this hypothesis (Kaye & Bagshawe, 1979).…”

Section: Histological Examinationmentioning

confidence: 89%

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Brain metastases in malignant teratoma: A review of four years' experience and an assessment of the role of tumour markers

Kaye¹,

Bagshawe²,

McElwain³

et al. 1979

Br J Cancer

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Summary. -Between 1973 and 1977,247 patients with malignant teratoma have been treated in two units in London. Seventeen have developed brain metastases, an overall incidence of 6 2%.The median survival from diagnosis of cerebral metastases is 6 weeks and all patients except one have died. The survivor is disease-free 12 months after completing treatment, which included extensive use of chemotherapy, surgery and radiotherapy.Serum gonadotrophin (HCG) and a-foetoprotein (AFP) estimations have been performed in 264 patients as a means of monitoring the effects of therapy. In 42 patients (37 of whom had Stage IV disease) the peak HCG level was > 104 iu/l, and the incidence of brain metastases in this group was 26%, significantly higher than in the group with HCG levels below 104 iu/l, for which the incidence of cerebral deposits was 1.8% (P<0-001). No significant correlation was seen between peak AFP levels and the incidence of brain metastasis.With the aim of improving results by earlier diagnosis, cerebrospinal fluid (CSF) specimens have been examined for HCG and AFP levels in 56 subjects, 9 of whom had brain metastases. A serum: CSF HCG ratio <40 is an accurate indication of the presence of brain metastases, and may have considerable predictive value. However, false -negative serum: CSF HCG ratios (>40) frequently occur in patients with proven brain deposits. Estimation of AFP in spinal fluid has not contributed to the early diagnosis of brain metastases in malignant teratoma.

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Section: Histological Examinationmentioning

confidence: 89%

“…Analysis for other putative tumour markers in spinal fluid (Kaye & Bagshawe, 1979) has not been performed in this series of teratoma patients.…”

Section: Histological Examinationmentioning

confidence: 99%

Brain metastases in malignant teratoma: A review of four years' experience and an assessment of the role of tumour markers

Kaye¹,

Bagshawe²,

McElwain³

et al. 1979

Br J Cancer

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“…These tumors markers can be extremely useful in diagnosis, serial evaluation of response to therapy, and diagnosis of persisting active disease in nongerminomatous GCTs [9] (germinomatous GCT may also secrete low levels of HCG-beta). It is now well established that nongerminomatous GCTs are much more difficult to cure than intracranial germinomas.…”

mentioning

confidence: 99%

Blood to cerebrospinal fluid human chorionic gonadotropin-beta ratios in intracranial germ cell tumors

Rogers

Sims²,

Plowman³

1998

FOC

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Levels of human chorionic gonadotropin-beta (HCG-beta) are elevated in up to 43% of patients with intracranial germ cell tumors (GCTs) and are useful in the diagnosis of these tumors and the follow up of such patients. The ratio of blood HCG-beta to lumbar cerebrospinal fluid (CSF) HCG-beta in these patients at presentation has not been defined. Twenty-two patients with intracranial GCTs have been treated at St. Bartholomew's Hospital over the past 15 years. Two (17%) of 12 germinomas and seven (70%) of 10 nongerminomatous GCTs had elevated blood HCG-beta at presentation. Four cases of pineal region GCTs (one of 12 germinomas and three of 10 nongerminomatous GCTs) had paired, elevated, blood and lumbar CSF HCG-beta levels. The mean blood to CSF ratio was 1:10 (range 1.7-18.4), which is substantially lower than the ratio of 286:1 reported in systemic GCTs. The authors confirm the finding of a previous single report showing that ventricular CSF HCG-beta sampling via an accessible ventriculoperitoneal shunt reservoir may give a spuriously negative result, and they discuss the pathophysiology of the blood-brain barrier in the pineal region and the implications of the intrathecal administration of chemotherapy.

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Central nervous system metastases of choriocarcinoma. 23 Years' experience at Charing Cross Hospital

Athanassiou

Begent

Newlands

et al. 1983

Cancer

165

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Between 1957 and February 1981, 782 patients received cytotoxic chemotherapy for gestational trophoblastic tumors (GTT) in the Department of Medical Oncology, Charing Cross Hospital (London, England). Sixty‐nine (8.8%) patients had central nervous system (CNS) metastases. Thirty‐three of them (48%) presented with CNS disease prior to treatment (CNS presentation group), and 36 (52%) developed CNS disease while on treatment, or relapsed in the CNS after an initial complete or partial remission (late CNS group). Treatment included systemic and intrathecal chemotherapy, and, in several cases neurosurgery, whole brain irradiation, and immunotherapy. Life‐table analysis projects an overall survival of 49% for the CNS presentation group and 6% for the late CNS group. Prognosis has improved with time; prior to 1974, 38% of the CNS presentation group and none of the late CNS group survived. After 1974 overall survival has been 80% in the CNS presentation group and 25% in the late CNS group. The principal elements in the successful management of such cases are: (1) CNS prophylaxis with intrathecal methotrexate for patients at risk of developing brain metastases; (2) early detection of CNS lesions by prompt recognition of their clinical features, measurement of the ratio of CSF to serum human chorionic gonadotropin concentration, and appropriate use of computerized tomography of the brain; and (3) a combination of systemic and intrathecal therapy for patients developing brain secondaries.

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Chemical Markers in Spinal Fluid for Tumours of the Central Nervous System (CNS)

Cited by 4 publications

References 26 publications

Brain metastases in malignant teratoma: A review of four years' experience and an assessment of the role of tumour markers

Brain metastases in malignant teratoma: A review of four years' experience and an assessment of the role of tumour markers

Blood to cerebrospinal fluid human chorionic gonadotropin-beta ratios in intracranial germ cell tumors

Central nervous system metastases of choriocarcinoma. 23 Years' experience at Charing Cross Hospital

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