Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Neuro Oncol. 2012 Mar;14(3):368-80. doi: 10.1093/neuonc/nor203. Epub 2011 Dec 12.
The diagnosis of primary central nervous system lymphoma (PCNSL) by radiographical examination is often difficult because of its similarity to other brain tumors. To test whether interleukin-10 (IL-10) and IL-6 can be used to distinguish PCNSL from other brain tumors that are radiographically similar, cerebrospinal fluid (CSF) levels of IL-10 and IL-6 were measured in 66 patients with intracranial tumors (PCNSLs: 26 cases; other brain tumors: 40 cases). In the patients with PCNSLs, the median CSF levels of IL-10 and IL-6 were 27 pg/mL and 5.4 pg/mL, respectively. The CSF IL-10 and IL-6 levels were significantly higher in PCNSLs than in the other brain tumors. To validate the diagnostic value of CSF IL-10 in PCNSL, we prospectively examined 24 patients with brain lesions that were suspected to be PCNSL. We observed that the CSF IL-10 levels were significantly higher in PCNSLs than in other brain tumors. At an IL-10 cutoff level of 9.5 pg/mL, the sensitivity and specificity were 71.0% and 100%, respectively. After therapy, the CSF IL-10 levels were decreased in all patients and were increased at relapse in most of these patients. Immunohistochemically, all PCNSLs, except for 1 unclassified PCNSL, expressed both IL-10 and IL-10 receptor-A. In the patients with high CSF IL-10, IL-10 expression levels in tumor were relatively higher, compared with low CSF IL-10; however, there was no significant difference between these groups. In addition, elevated CSF level of IL-10 was significantly associated with having a shorter progression-free survival (hazard ratio, 3.37; 95% confidence interval, 0.985-11.528; log-rank, P= .038). These results indicate that the CSF level of IL-10 may be a useful diagnostic and prognostic biomarker in patients with PCNSLs.
原发性中枢神经系统淋巴瘤（PCNSL）的影像学诊断常常较为困难，因为它与其他脑肿瘤相似。为了测试白细胞介素 10（IL-10）和 IL-6 是否可用于区分影像学相似的 PCNSL 和其他脑肿瘤，我们测量了 66 例颅内肿瘤患者（PCNSL：26 例；其他脑肿瘤：40 例）的脑脊液（CSF）中 IL-10 和 IL-6 的水平。在 PCNSL 患者中，CSF 中 IL-10 和 IL-6 的中位数分别为 27 pg/ml 和 5.4 pg/ml。PCNSL 患者的 CSF IL-10 和 IL-6 水平明显高于其他脑肿瘤患者。为了验证 CSF IL-10 在 PCNSL 中的诊断价值，我们前瞻性地检查了 24 例疑似 PCNSL 的脑病变患者。我们观察到，PCNSL 患者的 CSF IL-10 水平明显高于其他脑肿瘤患者。当 IL-10 截断值为 9.5 pg/ml 时，其敏感性和特异性分别为 71.0%和 100%。经治疗后，所有患者的 CSF IL-10 水平均降低，其中大多数患者复发时再次升高。免疫组织化学分析显示，除了 1 例未分类的 PCNSL 外，所有 PCNSL 均表达 IL-10 和 IL-10 受体-A。在 CSF IL-10 水平较高的患者中，肿瘤中 IL-10 的表达水平相对较高，与 CSF IL-10 水平较低的患者相比；然而，两组之间没有显著差异。此外，CSF 中升高的 IL-10 水平与无进展生存期较短显著相关（风险比，3.37；95%置信区间，0.985-11.528；对数秩，P=.038）。这些结果表明，CSF 中 IL-10 的水平可能是 PCNSL 患者有用的诊断和预后生物标志物。
