Division of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Acta Ophthalmol. 2020 Sep;98(6):e668-e673. doi: 10.1111/aos.14347. Epub 2020 Jan 29.
To evaluate the efficacy of the different diagnostic tests for vitreoretinal lymphoma (VRL).
A cohort of 150 patients with a presumed diagnosis of VRL. Vitrectomy samples were analysed for cytology, monoclonality [polymerase chain reaction (PCR)] and cytokine levels, and anterior chamber taps were analysed for cytokine levels. Vitreoretinal lymphoma (VRL) was diagnosed after confirming the clinical suspicion with vitreal or brain cytology.
Vitreoretinal lymphoma (VRL) was diagnosed in 78 patients. Vitreal cytology was positive for 53/132 patients (40.2%), 36/53 had positive cytology from both the eye and the brain. Additional 25 patients had positive brain cytology. Vitreal PCR for monoclonality was positive for 32/91 patients (35.2%). Vitreal cytokine levels of interleukin (IL)-10/IL-6 were >1 for 47/110 patients (43.1%). For cytology, PCR and cytokine analysis, the respective sensitivity was 73.6%, 46.0% and 81.4%, and the accuracy of the tests was 85.6%, 60.4% and 80.9%, respectively. All three tests were available for 79 patients. In this subset, for cytology, PCR and cytokine analysis the respective sensitivity was 79.5%, 41.0% and 82.1%, respectively, and the accuracy of the tests was 89.9%, 60.8% and 81.0%, respectively.
Cytokines analysis has an important role in the diagnosis of VRL. We suggest analysing cytokines levels in all cases suspected of VRL along with cytology and PCR analysis.
评估不同诊断检测方法在眼内淋巴瘤（VRL）中的作用。
对 150 例疑似 VRL 患者的病例进行回顾性分析。对玻璃体切除术样本进行细胞学、单克隆性[聚合酶链反应（PCR）]和细胞因子水平分析，对前房穿刺术样本进行细胞因子水平分析。通过玻璃体或脑细胞学检查确认临床怀疑后，诊断为 VRL。
78 例患者诊断为 VRL。132 例患者中有 53 例（40.2%）的玻璃体细胞学检查呈阳性，其中 36 例眼内和脑内均为阳性细胞学。另外 25 例患者的脑细胞学检查呈阳性。91 例患者中，32 例（35.2%）玻璃体 PCR 检测为单克隆性阳性。110 例患者中有 47 例（43.1%）的白细胞介素（IL）-10/IL-6 细胞因子水平>1。对于细胞学、PCR 和细胞因子分析，各自的敏感性分别为 73.6%、46.0%和 81.4%，检测的准确性分别为 85.6%、60.4%和 80.9%。79 例患者同时进行了这三种检测。在这一组中，细胞学、PCR 和细胞因子分析的敏感性分别为 79.5%、41.0%和 82.1%，检测的准确性分别为 89.9%、60.8%和 81.0%。
细胞因子分析在 VRL 的诊断中具有重要作用。我们建议在所有疑似 VRL 的病例中，同时进行细胞因子水平分析、细胞学和 PCR 分析。
