The Study Of Cerebrospinal Fluid Biological Markers In The Nervous System Tuberculosis Infection And Paraneoplastic Syndrome

Background:Tuberculosis infection is usually presented as tuberculous meningitis in the central nervous system. The incidence of tuberculous meningitis is more than 60% in intracranial infectious diseases. Cerebrospinal fluid biomarkers contribute to the diagnosis of tuberculous meningitis, and it has a certain value in the disease surveillance of tuberculous meningitis, therapeutic efficacy, prognosis judgement and pathogenesis research. Paraneoplastic neurological syndrome refers to some malignant tumor not direct invasion and metastasis nerve and/or muscle damage caused by a group of clinical syndrome, its duration and severity of the size and growth rate of cancer is not necessarily parallel. The diagnosis and differential diagnosis of paraneoplastic neurological syndrome has a certain degree of difficulty, in addition to looking for the primary tumor, the detection of the classic paraneoplastic syndromes biomarkers also contribute to its diagnosis and differential diagnosis.Purpose:To find high sensitivity and specificity biological markers in tuberculosis infection and paraneoplastic neurological syndrome by detecting RV2623 antigen, mannan binding lectin (MBL), anti-CV2 antibodies and anti-MA2 antibodies.Methods:To choose 28 cases of tuberculous meningitis,28 cases of paraneoplastic neurological syndromes,28 cases of control group. To detect content of RV2623 antigen, mannan binding lectin (MBL), anti-CV2 antibodies and anti-MA2 antibodies by ELISA, and find out their diagnostic value.Results:The CSF RV2623 antigen levels were significantly higher in the samples from the CG1 group than those from either the CG2 group or the MG group. The sensitivity, specificity of RV2623 antigen are 89.3% and 60.7%. The positive predictive value, negative predictive value of RV2623 antigen are 69.4% and 85%. The area under the ROC curve (AUC) of RV2623 antigenis 0.793. The CSF MBL levels were significantly higher in the samples from the CG1 group than those from either the CG2 group or the MG group. The sensitivity and specificity of MBL are 89.3% and 57.1%. The positive predictive value, negative predictive value, area under the ROC curve (AUC) of MBL are 67.6%,84.2% and 0.789. The levels of RV2623 antigen and MBL in CSF are in relevant relationships, the correlation coefficient is 0.372.The CSF anti-CV2 antibodies levels were significantly higher in the samples from the CG2 group than those from either the CG1 group or the MG group. The sensitivity and specificity of anti-CV2 antibodies are 82.1% and 48.2%. The positive predictive value negative predictive value, area under the ROC curve (AUC) of anti-CV2 antibodies are 61.3%,73% and 0.692.The CSF anti-MA2 antibodies levels were significantly higher in the samples from the CG2 group than those from either the CG1 group or the MG group. The sensitivity and specificity of anti-MA2 antibodies are 92.9% and 57.1%. The positive predictive value, negative predictive value, area under the ROC curve (AUC) of anti-MA2 antibodies are 68.4%,88.9% and 0.783. The levels of anti-CV2 antibodies and anti-MA2 antibodies in CSF are in relevant relationships, the correlation coefficient is 0.292.Conclusion:The CSF levels of RV2623 antigen and MBL are significantly higher in the CG1 group, which indicate that RV2623 antigen and MBL may be used as CSF biological marker in tuberculous meningitis. The CSF levels of anti-CV2 antibodies and anti-MA2 antibodies are significantly higher in the CG2 group, which indicate that anti-CV2 antibodies and anti-MA2 antibodies may be used as CSF biological marker in paraneoplastic neurological syndromes.There are significant relationships between RV2623 antigen and MBL in cerebrospinal fluid and also between anti-CV2 antibodies and anti-MA2 antibodies.