Prognostic value of serum s100 protein by elecsys s100 immunoassay in patients with spontaneous subarachnoid and intracerebral hemorrhages

S100B as a biomarker for brain metastases in patients with non-small cell lung cancer

Brain metastases are frequent in patients with lung cancer and a major cause of morbidity and mortality. Finding a biomarker predicting brain metastases could facilitate early start of treatment and thereby reduce morbidity and possibly improve overall survival. Previous studies suggest S100B as a possible biomarker for this purpose. This prospective study enrolled 185 patients with newly diagnosed stage IV non-small cell lung cancer (NSCLC). A total of 22 patients had brain metastases verified by magnetic resonance imaging or computed tomography at the time of enrollment. Serum S100B levels were measured in blood samples collected prior to any treatment from 22 patients who had brain metastases at enrollment and from 50 patients randomly selected from the remaining 163 patients without brain metastases at enrollment. No statistically significant difference was found in the levels of serum S100B between patients with and without brain metastases [range 0.018-0.209 µg/l, mean 0.049 µg/l, 95% confidence interval (CI), 0.032-0.061 µg/l] and (range 0.016-0.130 µg/i, mean 0.044 µg/l, 95% CI, 0.037-0.051 µg/l), respectively, (P=0.852). Univariate analysis of prognostic factors for S100B indicated a correlation (P<0.2) with sex (P=0.088) and histology (adenocarcinoma vs. squamous cell carcinoma/others) (P=0.028). In the multivariate analysis only histology (P=0.029) remained statistically significant. Conclusion: The present study found no significant correlation between the level of serum S100B and the presence of brain metastases in patients with advanced NSCLC. The clear cut-off of S100B in patients with and without brain metastases reported in other studies could not be verified in this study. Further studies investigating the role of S100B as a biomarker for brain metastases in non-small cell lung cancer are warranted.

Serum S100 protein could predict altered consciousness in glyphosate or glufosinate poisoning patients

BACKGROUND

Central nervous system (CNS) complications such as seizures and reduced consciousness are important in glufosinate and may occur in severe glyphosate poisoning. The aim of this study was to assess the possible role of serum S100B protein as a biochemical marker of CNS complications associated with glyphosate or glufosinate poisoning.

METHODS

The study enrolled 40 patients (23 glyphosate poisoning and 17 glufosinate poisoning). Altered consciousness and seizure were observed during hospitalization. S100B level was measured with fully automated modular analytic E170 system using electrochemoluminometric immunoassay.

RESULTS

Among 40 patients, neurologic features were observed in 12 patients with a median time to onset of 21.5 (IQR 8.25-24.75) h. Serum S100B concentrations measured on admission were higher in the group with neurologic features than in the group without neurologic features [0.148 μg/L (IQR 0.128-0.248) vs. 0.072 μg/L (IQR 0.047-0.084), p < .001]. Univariate analysis of measured patient raw parameters using a ROC curve showed that S100B was a significant predictor of neurologic features in glyphosate and glufosinate poisoning. The area under the ROC curve was 0.894 (95% confidential interval 0.791-0.998). When S100B was set at 0.0965, its sensitivity and specificity for predicting neurologic features in glyphosate and glufosinate poisoning were 92% and 82%, respectively.

CONCLUSIONS

In our pilot study, S100B was a significant predictor of neurologic complications in patients with glyphosate and glufosinate poisoning. Large prospective cohorts are needed to confirm this finding.

Predicting brain metastases of breast cancer based on serum S100B and serum HER2

Brain metastases are a major cause of morbidity and mortality in breast cancer. The aim of the current study was to evaluate the prediction of brain metastases based on serum S100B and human epidermal growth factor receptor 2 (HER2). A total of 107 breast cancer patients were included in the current study from two prospective cohort studies with either elevated serum HER2 levels >15 ng/ml or brain metastases verified by magnetic resonance imaging (MRI) or computer tomography (CT). Following the exclusion of six patients, the remaining 101 patients were divided into two groups: Group 0 (n=55), patients with normal MRI results; and group 1 (n=46), patients with brain metastases. The levels of serum S100B and HER2 in the two groups were analyzed prior to MRI or CT of the brain, and no significant differences were identified in the serum HER2 (P=0.060) or S100B levels (P=0.623) between the groups. The univariate analysis of prognostic factors for brain metastases showed a significant correlation with systemic disease (P<0.001), axillary lymph node metastases (P=0.001) and serum HER2 >30 ng/ml (P=0.002). Only systemic disease (P<0.001) remained statistically significant in the multivariate analysis. In conclusion, serum levels of S100B and HER2 did not predict the risk of brain metastases. In the multivariate analysis, brain metastases were only found to correlate with systemic disease. However, in the univariate analysis, serum HER2 levels >30 ng/ml were identified to correlate with increased risk of brain metastases, which calls for further investigation.