脑脊液细胞因子IL-6和IL-10表达水平在原发中枢神经系统淋巴瘤中的诊断价值  

The diagnostic value of IL-10 and IL-6 level in cerebrospinal fluid for primary central nervous system lymphoma

作　　者：陈锟[1] 樊妮[2] 关明[1] 

机构地区：[1]复旦大学附属华山医院北院检验科,上海201907 [2]复旦大学附属华山医院北院血液科,上海201907

出　　处：《中华检验医学杂志》2016年第8期585-588,共4页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨白细胞介素6（IL-6）和白细胞介素10（IL-10）在原发性中枢神经系统淋巴瘤脑脊液中的表达。方法收集2013年7月至2015年12月期间复旦大学附属华山医院北院就诊的原发性中枢神经系统淋巴瘤（PCNSL）40例、继发性中枢神经系统淋巴瘤（SCNSL）11例、脑转移瘤（BM）20例、中枢神经系统感染（CNSI）20例及其他神经系统疾病（ONSD）16例的血清和脑脊液，应用酶联免疫吸附法检测血清及脑脊液中IL-6及IL-10水平，各组总体水平差异采用Kruskal—Wallis法检验。两个独立样本的比较采用Mann—WhitneyU检验。采用ROC曲线分析法评价IL-6及IL-10水平在PCNSL诊断中的价值。结果PCNSL组、BM组、SCNSL组、CNSI组及ONSD组之间的血清IL-6及IL-10水平差异无统计学意义（日值分别为4．165和5．368，P均〉0．05）。CNSI脑脊液IL-6水平[623．73（184．37～1018．77）pg／m1]显著高于其他各组（ZPCNSL=51．36，ZSCNSL=28．18，ZBM=51．50，ZCNSI=85．45，ZONSD=42．16，P〈0．05）。CNSI及PCNSL脑脊液IL-10水平显著高于其他各组（ZPCNSL=74．50，ZSCNSL=34．68，ZBM=35．35，ZCNSI=72．95，ZONSD=15．66，P〈0．05）。PCNSL脑脊液IL-10水平[64．88（20．03～206．14）pg／m1]显著高于SCNSL[6．28（2．78—18．87）pg／ml，Z=-3．753，P〈0．051和BM[7．30（3．72～14．49）pg／m1．Z=-5．034，P〈0．05l；以及ONSD[3．14（2．931～4．20）pg／ml，Z=-5．786，P〈0．05]。脑脊液IL-6和IL-10水平在诊断PCNSL的ROC曲线下面积分别是：0．461和0．806，当IL-10为19．62pg／ml时，敏感度为77．5％（31／40），特异度为70．1％（47／67）；脑脊液IL-6和IL-10水平在诊断CNSI的ROC曲线下面积分别是：0．861和0．718。当IL-6为155．12pg／m1时，敏感度为80．O％（16／20），特异度为90．8％（79／87）；当IL-10为26．76pg／ml时，敏感度为80．0％（16／20），特异度为66．7％（58／87）。结论原发Objective To investigate the expression of Interleukin 6 （IL-6） and interleukin 10 （IL-10） in cerebrospinal fluid（CSF） in patients with primary central nervous system lymphoma. Methods Forty cases of primary central nervous system lymphoma （PCNSL） , 11 cases of secondary central nervous system lymphomas （SCNS） , 20 cases of brain metastase, 20 cases of central nervous system infection and 16 cases of other nervous system disease（ONSD） were collected during the period from July 2013 to December 2015 in Fudan University Hua Shah Hospital North. Enzyme linked immunosorbent assay was used to detect the levels of IL-6 and IL-10 in serum and eerebrospinal fluid. The overall level of each group was compared using Kruskal-Wallis test. Two independent samples were compared by U Mann-Whitney test. The diagnostic value of IL-6 and IL-10 levels for PCNSL was evaluated by ROC curve. Results In PCNSL group, BM group, SCNSL group, CNSI group and ONSD group, the serum levels of IL-6 and IL-IO were not statistically significant （H values were 4. 165 and 5. 368, respectively, P 〉0. 05 ）. IL-6 levels in CSF were significantly higher in CNSI[623.73 （ 1018.77 - 184. 37） pg/mllthan those in other groups （ZPcNSL =51.36, Zsc^sL = 28. 18, ZBM = 51.50, ZCNSI = 85.45, ZONSD = 42. 16, P〈 0.05） . The levels of IL-10 in CSF were significantly higher in CNSI and PCNSL than those in other groups （ ZPCNSL 7- 74. 50, ZSCNSL = 34. 68, ZBM = 35.35, ZcNsl = 72. 95, ZONSd= 15. 66, P 〈 0. 05）. The levels of IL-IO in CSF in PCNSL group [ 64. 88 （20. 03 - 206. 14） pg/ml ] was significantly higher than in SCNSL group [ 6. 28 （ 2. 78 - 18.87 ） pg/ml, Z = - 3. 753,P 〈 0. 05 ], BM group [ 7.30 （ 3.72 - 14.49 ） pg/ml, Z = - 5. 034, P 〈 0. 05 ] and ONSD group [ 3. 14 （2. 931 -4. 20）pg/ml, Z = -5. 786, P 〈 0. 05 ]. The area under the ROC curve of IL-6 and IL-IO levels in CSF was O. 461 and O. 806 respectively for the diagnosis of PCNSL. When IL-10 was 19. 62 pg/ml, the sensitivity was 77.5% �

关 键 词：中枢神经系统肿瘤 淋巴瘤 白细胞介素6 白细胞介素10 脑脊髓液 

分 类 号：R739.4[医药卫生—肿瘤] R730.43[医药卫生—临床医学]