research
Proteomics of body fluids
- Publication date
- 10 October 2007
- Publisher
- In this thesis we present newly developed methods
for biomarker discovery. We applied these methods to discover
biomarkers of leptomeningeal metastasis (LM) in the cerebrospinal
fluid (CSF) from breast cancer patients and in serum from patients
with prostate cancer. Early diagnosis of LM remains challenging
because 25% of CSF samples test false negative at first cytological
examination. In addition, the sensitivity and specificity of magnetic
resonance imaging (MRI) in diagnosing LM in solid tumors are
approximately 75%. Early diagnosis and initiation of treatment of LM
are essential to prevent neurological deterioration. We therefore set
out to find biomarkers to increase the accuracy of early diagnostic
testing in LM.
For prostate cancer a biomarker in the form of prostate specific
antigen (PSA) is available. The specificity of this marker is however
rather poor, in screening studies like the European Randomized study
of Screening for Prostate Cancer (ERSPC) 75% of men with an elevated
PSA level > 3 ng/ml are false positive. Resulting in a group of men
that undergo unnecessary treatment with a risk of complications
including impotence and incontinence. New markers in addition to PSA
could help to reduce the large number of false positive diagnosed
patients and to predict the course of the disease.