Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection
Abstract Objective To find an adequate cut‐off point for beta trace protein (β‐TP) in nasal secretion (NS) and validate this diagnostic test with a large sample of patients. Likewise, we evaluated β‐TP test efficacy to confirm the cerebrospinal fluid (CSF) leakage closure after treatment. Methods We...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.1150 |
| _version_ | 1797648936543977472 |
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| author | María‐Teresa Almela Javier Navarro‐Zaragoza María‐Luisa Laorden Fernando Sánchez‐Celemín Pilar Almela |
| author_facet | María‐Teresa Almela Javier Navarro‐Zaragoza María‐Luisa Laorden Fernando Sánchez‐Celemín Pilar Almela |
| author_sort | María‐Teresa Almela |
| collection | DOAJ |
| description | Abstract Objective To find an adequate cut‐off point for beta trace protein (β‐TP) in nasal secretion (NS) and validate this diagnostic test with a large sample of patients. Likewise, we evaluated β‐TP test efficacy to confirm the cerebrospinal fluid (CSF) leakage closure after treatment. Methods We performed a retrospective analysis with 207 samples from 162 patients with suspected CSF leakage received in the Hospital Universitario Virgen de la Arrixaca between 2010 and 2016. Twenty‐five samples were included in the control group. Samples were obtained from NS through a swab to determine β‐TP using a nephelometry‐based assay. Sensitivity, specificity, and area under the curve (AUC) for β‐TP in NS were assessed using the receiver operator characteristic (ROC) analysis. Results Using imaging techniques, the diagnosis of CSF leak was confirmed in 57 patients (35.19%), while 105 had a negative diagnosis (64.81%). Patients with CSF leakage had significantly higher β‐TP values in NS (16.07 ± 16.94 mg/L, p < .001) than the control group (0.33 ± 0.12 mg/L) and patients without CSF leakage (0.61 ± 2.34 mg/L). Applying a 1 mg/L cut‐off point resulted in 96.5% sensitivity and 97.1% specificity. Positive and negative predictive values (PPV and NPV) at this cut‐off were 94.9% and 98.6%, respectively. Finally, this cut‐off point yields a test efficacy for CSF leak diagnosis of 97% (95% CI 92.9–98.9). Conclusion Our study has established a 1 mg/L β‐TP concentration in NS as a cut‐off point for CSF leakage diagnosis with high sensibility and specificity. These results suggest that β‐TP analysis could be useful to check CSF leak resolution. Level of Evidence 4. |
| first_indexed | 2024-03-11T15:39:14Z |
| format | Article |
| id | doaj.art-730b949d13114a0890fe0ce489f28c07 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-11T15:39:14Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-730b949d13114a0890fe0ce489f28c072023-10-26T12:36:34ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-10-01851233123910.1002/lio2.1150Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detectionMaría‐Teresa Almela0Javier Navarro‐Zaragoza1María‐Luisa Laorden2Fernando Sánchez‐Celemín3Pilar Almela4Hospital Universitario Los Arcos del Mar Menor Murcia SpainInstitute of Biomedical Research of Murcia (IMIB), Campus de Ciencias de la Salud Murcia SpainInstitute of Biomedical Research of Murcia (IMIB), Campus de Ciencias de la Salud Murcia SpainInstitute of Biomedical Research of Murcia (IMIB), Campus de Ciencias de la Salud Murcia SpainInstitute of Biomedical Research of Murcia (IMIB), Campus de Ciencias de la Salud Murcia SpainAbstract Objective To find an adequate cut‐off point for beta trace protein (β‐TP) in nasal secretion (NS) and validate this diagnostic test with a large sample of patients. Likewise, we evaluated β‐TP test efficacy to confirm the cerebrospinal fluid (CSF) leakage closure after treatment. Methods We performed a retrospective analysis with 207 samples from 162 patients with suspected CSF leakage received in the Hospital Universitario Virgen de la Arrixaca between 2010 and 2016. Twenty‐five samples were included in the control group. Samples were obtained from NS through a swab to determine β‐TP using a nephelometry‐based assay. Sensitivity, specificity, and area under the curve (AUC) for β‐TP in NS were assessed using the receiver operator characteristic (ROC) analysis. Results Using imaging techniques, the diagnosis of CSF leak was confirmed in 57 patients (35.19%), while 105 had a negative diagnosis (64.81%). Patients with CSF leakage had significantly higher β‐TP values in NS (16.07 ± 16.94 mg/L, p < .001) than the control group (0.33 ± 0.12 mg/L) and patients without CSF leakage (0.61 ± 2.34 mg/L). Applying a 1 mg/L cut‐off point resulted in 96.5% sensitivity and 97.1% specificity. Positive and negative predictive values (PPV and NPV) at this cut‐off were 94.9% and 98.6%, respectively. Finally, this cut‐off point yields a test efficacy for CSF leak diagnosis of 97% (95% CI 92.9–98.9). Conclusion Our study has established a 1 mg/L β‐TP concentration in NS as a cut‐off point for CSF leakage diagnosis with high sensibility and specificity. These results suggest that β‐TP analysis could be useful to check CSF leak resolution. Level of Evidence 4.https://doi.org/10.1002/lio2.1150cerebrospinal fluid leakagecut‐offnephelometryrhinorreaβ‐trace protein |
| spellingShingle | María‐Teresa Almela Javier Navarro‐Zaragoza María‐Luisa Laorden Fernando Sánchez‐Celemín Pilar Almela Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection Laryngoscope Investigative Otolaryngology cerebrospinal fluid leakage cut‐off nephelometry rhinorrea β‐trace protein |
| title | Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection |
| title_full | Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection |
| title_fullStr | Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection |
| title_full_unstemmed | Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection |
| title_short | Cut‐off value for β‐trace protein (β‐TP) as a rapid diagnostic of cerebrospinal fluid (CSF) leak detection |
| title_sort | cut off value for β trace protein β tp as a rapid diagnostic of cerebrospinal fluid csf leak detection |
| topic | cerebrospinal fluid leakage cut‐off nephelometry rhinorrea β‐trace protein |
| url | https://doi.org/10.1002/lio2.1150 |
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