Journal of Korean Neurosurgical Society

  • 제44권5호
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  • Pages.308-313
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  • 2008
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Prognostic Value of Serum S100 Protein by Elecsys S100 Immunoassay in Patients with Spontaneous Subarachnoid and Intracerebral Hemorrhages

  • Yoon, Seok-Mann (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Choi, Young-Jin (Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Hwi-Jun (Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Shim, Jai-Joon (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Bae, Hack-Gun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Yun, Il-Gyu (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
  • 발행 : 2008.11.28
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초록

Objective: The serum S100 protein has been known to reflect the severity of neuronal damage. The purpose of this study was to assess the prognostic value of the serum S100 protein by Elecsys S100 immunoassay in patients with subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) and to establish reference value for this new method. Methods: Serum S100 protein value was measured at admission, day 3 and 7 after bleeding in 42 consecutive patients (SAH : 20, ICH : 22) and 74 healthy controls, prospectively. Admission Glasgow coma scale (GCS) score, Hunt & Hess grade and Fisher grade for SAH, presence of intraventricular hemorrhage, ICH volume, and outcome at discharge were evaluated. Degrees of serum S100 elevation and their effect on outcomes were compared between two groups. Results: Median S100 levels in SAH and ICH groups were elevated at admission (0.092 versus $0.283{\mu}g/L$) and at day 3 (0.110 versus $0.099{\mu}g/L$) compared to healthy controls ($0.05{\mu}g/L;$ p<0001). At day 7, however, these levels were normalized in both groups. Time course of S100 level in SAH patient was relatively steady at least during the first 3 days, whereas in ICH patient it showed abrupt S100 surge on admission and then decreased rapidly during the next 7 days, suggesting severe brain damage at the time of bleeding. In ICH patient, S100 level on admission correlated well with GCS score (r=-0.859; p=0.0001) and ICH volume (r=0.663; p=0.001). A baseline S100 level more than $0.199{\mu}g/L$ predicted poor outcome with 92% sensitivity and 90% specificity. Logistic regression analyses showed Ln (S100) on admission as the only independent predictor of poor outcome (odd ratio 36.1; 95% CI, 1.98 to 656.3) Conclusion: Brain damage in ICH patient seems to develop immediately after bleeding, whereas in SAH patients it seems to be sustained for few days. Degree of brain damage is more severe in ICH compared to SAH group based on the S100 level. S100 level is considered an independent predictor of poor outcome in patient with spontaneous ICH, but not in SAH. Further study with large population is required to confirm this result.

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참고문헌

  1. Alber B, Hein R, Garbe C, Caroli U, Luppa PB : Multicenter evaluation of the analytical and clinical performance of the Elecsys S100 immunoassay in patients with malignant melanoma. Clin Chem Lab Med 43 : 557-563, 2005 https://doi.org/10.1515/CCLM.2005.097
  2. Blomquist S, Johnsson P, Lührs C, Malmkvist G, Solem JO, Alling C, et al : The appearance of S-100 protein in serum during and immediately after cardiopulmonary bypass surgery : a possible marker for cerebral injury. J Cardiothorac Vasc Anesth 11 : 699-703, 1997 https://doi.org/10.1016/S1053-0770(97)90160-9
  3. Butterworth RJ, Sherwood RA, Bath PM : Serum S-100 protein in acute stroke. Stroke 29 : 730, 1998 https://doi.org/10.1161/01.STR.29.3.730
  4. Buttner T, Weyers S, Postert T, Sprengelmeyer R, Kuhn W : S-100 protein : serum marker of focal brain damage after ischemic territorial MCA infarction. Stroke 28 : 1961-1965, 1997 https://doi.org/10.1161/01.STR.28.10.1961
  5. Delgado P, Alvarez Sabin J, Santamarina E, Molina CA, Quintana M, Rosell A, et al : Plasma S100B level after acute spontaneous intracerebral hemorrhage. Stroke 37 : 2837-2839, 2006 https://doi.org/10.1161/01.STR.0000245085.58807.ad
  6. Foerch C, Singer OC, Neumann-Haefelin T, du Mesnil de Rochemont R, Steinmetz H, Sitzer M : Evaluation of serum S100B as a surrogate marker for long-term outcome and infarct volume in acute middle cerebral artery infarction. Arch Neurol 62 : 1130-1134, 2005 https://doi.org/10.1001/archneur.62.7.1130
  7. Gebel JM, Sila CA, Sloan MA, Granger CB, Weisenberger JP, Green CL, et al : Comparison of the ABC/2 estimation technique to computer-assisted volumetric analysis of intraparenchymal and subdural hematomas complicating the GUSTO-1 trial. Stroke 29 : 1799-1801, 1998 https://doi.org/10.1161/01.STR.29.9.1799
  8. Haimoto H, Hosoda S, Kato K : Differential distribution of immunoreactive S100-alpha and S100-beta proteins in normal nonnervous human tissues. Lab Invest 57 : 489-498, 1987
  9. Herrmann M, Curio N, Jost S, Grubich C, Ebert AD, Fork ML, et al : Release of biochemical markers of damage to neuronal and glial brain tissue is associated with short and long term neuropsychological outcome after traumatic brain injury. J Neurol Neurosurg Psychiatry 70 : 95-100, 2001 https://doi.org/10.1136/jnnp.70.1.95
  10. Kahn HJ, Baumal R, Van Eldik LJ, Dunn RJ, Marks A : Immunoreactivity of S100 beta in heart, skeletal muscle, and kidney in chronic lung disease : possible induction by cAMP. Mod Pathol 4 : 698-701, 1991
  11. Kanner AA, Marchi N, Fazio V, Mayberg MR, Koltz MT, Siomin V, et al : Serum S100beta : a noninvasive marker of blood-brain barrier function and brain lesions. Cancer 97 : 2806-2813, 2003 https://doi.org/10.1002/cncr.11409
  12. Korfias S, Stranjalis G, Papadimitriou A, Psachoulia C, Daskalakis G, Antsaklis A, et al : Serum S-100B protein as a biochemical marker of brain injury : a review of current concepts. Curr Med Chem 13 : 3719-3731, 2006 https://doi.org/10.2174/092986706779026129
  13. Missler U, Wiesmann M, Friedrich C, Kaps M : S-100 protein and neuron-specific enolase concentrations in blood as indicators of infarction volume and prognosis in acute ischemic stroke. Stroke 28 : 1956-1960, 1997 https://doi.org/10.1161/01.STR.28.10.1956
  14. Moore BW : A soluble protein characteristic of the nervous system. Biochem Biophys Res Commun 19 : 739-744, 1965 https://doi.org/10.1016/0006-291X(65)90320-7
  15. Muller K, Elverland A, Romner B, Waterloo K, Langbakk B, Unden J, et al : Analysis of protein S-100B in serum : a methodological study. Clin Chem Lab Med 44 : 1111-1114, 2006 https://doi.org/10.1515/CCLM.2006.211
  16. Mussack T, Kirchhoff C, Buhmann S, Biberthaler P, Ladurner R, Gippner-Steppert C, et al : Significance of Elecsys S100 immunoassay for real-time assessment of traumatic brain damage in multiple trauma patients. Clin Chem Lab Med 44 : 1140-1145, 2006 https://doi.org/10.1515/CCLM.2006.190
  17. Oertel M, Schumacher U, McArthur DL, Kastner S, Boker DK : S- 100B and NSE : markers of initial impact of subarachnoid haemorrhage and their relation to vasospasm and outcome. J Clin Neurosci 13 : 834-840, 2006 https://doi.org/10.1016/j.jocn.2005.11.030
  18. Oh EJ, Kim YM, Jegal DW, Kahng J, Park YJ, Han K : Diagnostic value of Elecsys S100 as a marker of acute brain injury in the emergency department. J Clin Lab Anal 21 : 387-392, 2007 https://doi.org/10.1002/jcla.20201
  19. Raabe A, Grolms C, Sorge O, Zimmermann M, Seifert V : Serum S- 100B protein in severe head injury. Neurosurgery 45 : 477-483, 1999 https://doi.org/10.1097/00006123-199909000-00012
  20. Smit LH, Korse CM, Bonfrer JM : Comparison of four different assays for determination of serum S-100B. Int J Biol Markers 20 : 34-42, 2005 https://doi.org/10.1177/172460080502000106
  21. Stranjalis G, Korfias S, Psachoulia C, Kouyialis A, Sakas DE, Mendelow AD : The prognostic value of serum S-100B protein in spontaneous subarachnoid haemorrhage. Acta Neurochir (Wien) 149 : 231-237; discussion 237-238, 2007 https://doi.org/10.1007/s00701-006-1106-9
  22. Weiss N, Sanchez-Pena P, Roche S, Beaudeux JL, Colonne C, Coriat P, et al : Prognosis value of plasma S100B protein levels after subarachnoid aneurysmal hemorrhage. Anesthesiology 104 : 658- 666, 2006 https://doi.org/10.1097/00000542-200604000-00008
  23. Wiesmann M, Missler U, Hagenstrom H, Gottmann D : S-100 protein plasma levels after aneurysmal subarachnoid haemorrhage. Acta Neurochir (Wien) 139 : 1155-1160, 1997 https://doi.org/10.1007/BF01410976

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