脑脊液总蛋白与脑脊液细胞因子水平在中枢神经系统淋巴瘤中的临床价值研究  

Clinical Value of Cerebrospinal Fluid Total Protein and Cerebrospinal Fluid Cytokine Levels in Central Nervous System Lymphoma

作　　者：罗欣 彭余 唐鑫怡 张亚坤 陈双 蒋亭亭 刘耀 杨再林 LUO Xin;PENG Yu;TANG Xin-yi;ZHANG Ya-kun;CHEN Shuang;JIANG Ting-ting;LIU Yao;YANG Zai-lin(Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment,Chongqing University Cancer Hospital,Chongqing 400030,China;School of Medicine,Chongqing University,Chongqing 400030,China)

机构地区：[1]重庆大学附属肿瘤医院血液肿瘤中心、肿瘤转移与个体化诊治转化研究重庆市重点实验室,重庆400030 [2]重庆大学医学院,重庆400030

出　　处：《中国生物工程杂志》2023年第12期119-127,共9页China Biotechnology

基　　金：中央高校基本科研业务费(2022CDJYGRH-001)资助项目。

摘　　要：目的:探讨脑脊液中总蛋白与细胞因子水平对中枢神经系统淋巴瘤(central nervous system lymphoma,CNSL)的诊断价值及对预后的影响。方法:收集2021年10月至2023年2月在重庆大学附属肿瘤医院行脑脊液检测的患者43例,其中诊断为CNSL的患者18例,为CNSL组,临床存在淋巴瘤中枢侵犯高风险因素但未发生淋巴瘤中枢侵犯的患者25例,为对照组。收集患者临床基本信息、脑脊液生化指标检测及脑脊液细胞因子检测的结果,分析脑脊液相关指标对患者预后的影响。结果:CNSL组患者的脑脊液总蛋白及细胞因子TNF-α、TNF-β、IL-17A、IL-6、IL-10的表达水平显著高于对照组(P<0.05)。脑脊液总蛋白联合细胞因子TNF-α、TNF-β、IL-17A、IL-6、IL-10检测诊断CNSL的曲线下面积(area under the curve,AUC)为0.957,灵敏度为94.1%,特异度为95.5%,显著高于总蛋白单项指标和仅脑脊液细胞因子联合的诊断价值(P<0.05)。CNSL组和对照组的2年总生存率分别为29.1%、56.0%,2年无进展生存率分别为23.1%、68.0%。CNSL组患者中位无进展生存期更短(P=0.03),两组的中位总生存期无统计学意义(P=0.11)。脑脊液总蛋白高水平,细胞因子TNF-α、IL-6、IL-10高表达,以及IL-17A和TNF-β低表达患者的无进展生存期和总生存期更短,但差异无显著统计学意义(P>0.05)。结论:CNSL患者预后较淋巴瘤中枢转移高风险患者预后更差,脑脊液总蛋白联合细胞因子TNF-α、TNF-β、IL-17A、IL-6、IL-10的表达水平能辅助诊断CNSL,其表达水平对CNSL患者预后具有一定影响。Objective:To investigate the diagnostic value of total protein and cytokine levels in cerebrospinal fluid(CSF)on central nervous system lymphoma(CNSL)and its impact on prognosis.Methods:A total of 43 patients who underwent cerebrospinal fluid testing at Chongqing University Cancer Hospital between October 2021 and February 2023 were enrolled into our study.Eighteen patients diagnosed with CNSL were in the CNSL group,and 25 patients with clinical high⁃risk factors for central invasion of lymphoma but without central nervous infiltration of lymphoma were in the control group.The basic clinical information,CSF biochemical indexes and CSF cytokine were collected.Mann⁃Whitney U test and t test were used to compare the differences of CSF related indexes between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of CSF related indicators for CNSL patients,and the Kaplan⁃Meier curve was used to analyze the effect of CSF related indexes on the prognosis of patients.Results:The CNSL group had significantly higher levels of CSF total protein and CSF TNF⁃α,TNF⁃β,IL⁃17A,IL⁃6,and IL⁃10 than the control group(P<0.05).The area under the curve(AUC)of CSF total protein combined with cytokines TNF⁃α,TNF⁃β,IL⁃17A,IL⁃6 and IL⁃10 in the diagnosis of CNSL was 0.957,with 94.1%sensitivity,and 95.5%specificity,which was significantly higher than the diagnostic value of CSF total protein and CSF cytokines alone(P<0.05).The 2⁃year overall survival(OS)rates of the CNSL and the control groups were 29.1%and 56.0%,and the 2⁃year progression⁃free survival(PFS)rates were 23.1%and 68.0%,respectively.Patients in the CNSL group had shorter median PFS(P=0.03),and there was no significant difference in median OS between the two groups(P=0.11).Patients with high level of CSF total protein level,high expression of CSF TNF⁃α,IL⁃6,and IL⁃10 and low expression of CSF IL⁃17A and TNF⁃βhad shorter PFS and OS,but the differences were not statistically significa

关 键 词：中枢神经系统肿瘤 淋巴瘤中枢转移高风险 脑脊液 细胞因子 

分 类 号：Q354[生物学—遗传学]