The S100B Protein Could Be Used as Adjuvant Diagnostic Tool in Acute Ischemic Stroke
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Background: In the emergency department, the diagnosis of ischemic stroke is difficult because the diagnostic modalities are limited to non-contrast brain CT and neurologic examination. Serum S100B protein, a bio-marker for ischemic stroke, is needed as an additional diagnostic aid in acute ischemic stroke. Methods: We retrospectively reviewed 50 patients diagnosed with ischemic stroke between August 2007 and December 2008 by brain MRI after brain CT and serum S100B measurement in the emergency department. The serum levels of S100B protein were analyzed and the diagnostic sensitivity of non-contrast brain CT combined with abnormal elevation of S100B protein was compared with that of non-contrast brain CT alone. Results: The overall sensitivity of non-contrast brain CT in the diagnosis of ischemia was 54%. S100B protein in early ischemia had a sensitivity of 58%. However, combining non-contrast brain CT and S100B increased the sensitivity to 74%. Conclusions: A biomarker-based diagnostic test would not replace the necessity for CT or other early imaging studies, and before contemplating any reperfusion strategy, neuro-imaging must be performed to rule out intracranial hemorrhage. However, S100B protein, a serum bio-marker, is able to help emergency physicians evaluate patients with suspected ischemic stroke and decide on treatment.
Abstract
Background: In the emergency department, the diagnosis of ischemic stroke is difficult because the diagnostic modalities are limited to non-contrast brain CT and neurologic examination. Serum S100B protein, a bio-marker for ischemic stroke, is needed as an additional diagnostic aid in acute ischemic stroke. Methods: We retrospectively reviewed 50 patients diagnosed with ischemic stroke between August 2007 and December 2008 by brain MRI after brain CT and serum S100B measurement in the emergency department. The serum levels of S100B protein were analyzed and the diagnostic sensitivity of non-contrast brain CT combined with abnormal elevation of S100B protein was compared with that of non-contrast brain CT alone. Results: The overall sensitivity of non-contrast brain CT in the diagnosis of ischemia was 54%. S100B protein in early ischemia had a sensitivity of 58%. However, combining non-contrast brain CT and S100B increased the sensitivity to 74%. Conclusions: A biomarker-based diagnostic test would not replace the necessity for CT or other early imaging studies, and before contemplating any reperfusion strategy, neuro-imaging must be performed to rule out intracranial hemorrhage. However, S100B protein, a serum bio-marker, is able to help emergency physicians evaluate patients with suspected ischemic stroke and decide on treatment.
참고문헌 (9)
- Laskowitz DT, "BRAIN Study Group: Clinical usefulness of a biomarker- based diagnostic test for acute stroke: the Biomarker Rapid Assessment in Ischemic Injury (BRAIN) study", Stroke, 40, pp.77~85 (2009)
- Moore BW, "A soluble protein characteristic of the nervous system", Biochem Biophys Res Commun, 19, pp.739~744 (1965)
- Boyes BE, "Immunohistochemical co-localization of S-100b and the glial fibrillary acidic protein in rat brain", Neuroscience, 17, pp.857~865 (1986)
- Fassbender K, "Leakage of brain-originated proteins in peripheral blood: temporal profile and diagnostic value in early ischemic stroke", J Neurol Sci, 148, pp.101~105 (1997)
- Foerch C, "Evaluation of serum S100B as a surrogate marker for long-term outcome and infarct volume in acute middle cerebral artery infarction", Arch Neurol, 62, pp.1130~1134 (2005)
- Jauch EC, "NINDS rt-PA Stroke Study Group: Association of serial biochemical markers with acute ischemic stroke: the National Institute of Neurological Disorders and Stroke recombinant tissue plasminogen activator stroke study", Stroke, 37, pp.2508~2513 (2006)
- Rovira A, "Distribution territories and causative mechanisms of ischemic stroke", Eur Radiol, 15, pp.416~426 (2005)
- Dassan P, "Criteria for a clinically informative serum biomarker in acute ischaemic stroke: a review of S100B", Cerebrovasc Dis, 27, pp.295~302 (2009)
- Whiteley W, "Blood markers for the prognosis of ischemic stroke: a systematic review", Stroke, 40, pp.e380~389 (2009)