脑脊液白细胞介素10在原发性中枢神经系统淋巴瘤中的诊断价值  

The diagnostic value of cerebrospinal fluid interleukin-10 in primary central nervous system lymphoma

作　　者：孙慧 高赛 武雷 黄德晖 SUN Hui;GAO Sai;WU Lei;HUANG Dehui(不详;Department of Neurology,the First Medical Centre,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心神经内科医学部,100853

出　　处：《中国神经免疫学和神经病学杂志》2024年第1期13-19,共7页Chinese Journal of Neuroimmunology and Neurology

基　　金：中国研究型医院学会科研课题(Y2023FH-SJKX09)。

摘　　要：目的探讨脑脊液白细胞介素10(interleukin 10,IL-10)在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)中的诊断价值。方法收集作者医院2019-3-1—2022-12-31就诊并确诊的15例PCNSL患者、35例中枢神经系统脱髓鞘疾病(inflammatory demyelinating diseases of the CNS,IDDs)患者和6例原发性中枢神经系统血管炎(primary central nervous system vasculitis,PCNSV)患者的临床资料,采用自动电化学发光免疫法检测各组患者血清和脑脊液白细胞介素6(IL-6)和IL-10水平,采用多组秩和检验分析组间血清和脑脊液IL-6、IL-10水平的差异,采用Spearman相关分析PCNSL患者脑脊液IL-10与患者性别、病变部位、年龄、病灶数目、病程、病灶的最大径、病灶的最大标准摄取值(SUVmax)之间的关系。结果与IDDs组和PCNSV组比较,PCNSL患者脑脊液IL-10水平升高(P<0.01);ROC分析结果显示,脑脊液IL-10鉴别诊断PCNSL的曲线下面积为1,以11.45 pg/mL为临界值,其诊断的敏感性和特异性均为100%;Spearman相关性分析结果显示,PCNSL患者脑脊液IL-10与患者性别、年龄、病灶数目、病程、病灶的最大径、SUVmax均无相关性(P>0.05)。结论针对无法取得脑活检且疑诊PCNSL的患者于治疗前进行IL-10检测具有重要意义,脑脊液IL-10升高强烈提示PCNSL的诊断。Objective To investigate the diagnostic value of cerebrospinal fluid(CSF)interleukin-10(IL-10)in primary central nervous system lymphoma(PCNSL).Methods The clinical data of 15 cases of PCNSL,35 cases of inflammatory demyelinating diseases of the central nervous system(IDDs)and 6 cases of primary central nervous system vasculitis(PCNSV)were collected from the authors hospital between March 1st,2019 and December 31th,2022.The levels of interleukin 6(IL-6)and IL-10 in serum and CSF of the above patients were detected by automatic electrochemiluminescence immunoassay,the differences among the groups were analyzed by multi-group rank sum test.Spearman correlation was used to analyze the relationship between CSF IL-10 and gender,age,number of lesions,course of disease,maximum diameter of lesions,and maximum standard uptake value of lesions(SUVmax)in PCNSL patients.Results Compared with the IDDs and PCNSV groups,CSF IL-10 level in PCNSL patients was significantly increased(P<0.01),the area under receiver operator characteristic curve(ROC)was 1,and the sensitivity and specificity were both 100%with 11.45 pg/mL as the critical value.Spearman correlation analysis suggested that there was no correlation between CSF IL-10 and gender,age,number of lesions,course of disease,maximum diameter of lesions,and SUVmax in PCNSL patients(P>0.05).Conclusions It is important to detect IL-10 before treatment for patients who are suspected PCNSL and cannot obtain brain biopsy.The elevation of IL-10 in CSF strongly suggests the diagnosis of PCNSL.

关 键 词：原发性中枢神经系统淋巴瘤 脑脊液 白细胞介素10 脑组织活检 

分 类 号：R744.52[医药卫生—神经病学与精神病学]