Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 200040 Shanghai, China.
Department of Laboratory Medicine, Shanghai University of Medicine and Health Sciences, 201318, Shanghai, China.
Clin Chim Acta. 2022 Aug 1;533:48-52. doi: 10.1016/j.cca.2022.06.011. Epub 2022 Jun 16.
Cerebrospinal fluid (CSF) free light chain (FLC) detection has been proposed as a tool for diagnosing primary central nervous system lymphoma (PCNSL), but there is no consensus on the appropriate reference range and its value for monitoring chemotherapy efficacy has not been investigated in Chinese PCNSL patients. We assessed the application potential of CSF FLC ratios for diagnosing PCNSL and monitoring associated treatment efficacy.
Kappa (κ) and lambda (λ) FLC were measured by nephelometry in CSF samples of patients with PCNSL (n = 45), other neurological diseases (n = 30), and normal controls (n = 60). Results of κ/λ FLC ratios (FLCr) were correlated with patients' diagnoses and receiver operating characteristic analysis was used to determine accuracy. In PCNSL patients, FLCr analysis was compared between PCNSL before and after treatment.
κ FLC and FLCr concentrations in PCNSL were significantly higher than in patients without PCNSL (P < 0.05). The optimal cut-off for FLCr was 0.35, with diagnostic sensitivity and specificity of 78% and 72%, respectively. FLCr concentrations decreased after chemotherapy.
CSF FLC is a novel biomarker for diagnosis and chemotherapy efficacy monitoring in PCNSL.
脑脊液（CSF）游离轻链（FLC）检测已被提议作为诊断原发性中枢神经系统淋巴瘤（PCNSL）的一种工具，但对于合适的参考范围尚未达成共识，其在监测中国 PCNSL 患者化疗效果方面的价值也尚未得到研究。我们评估了 CSF FLC 比值在诊断 PCNSL 和监测相关治疗效果方面的应用潜力。
采用散射比浊法检测 PCNSL 患者（n=45）、其他神经系统疾病患者（n=30）和正常对照者（n=60）的 CSF 中的κ和λ FLC。κ/λ FLC 比值（FLCr）的结果与患者的诊断相关，并进行了接收者操作特征分析以确定其准确性。在 PCNSL 患者中，比较了治疗前后的 FLCr 分析。
PCNSL 患者的κ FLC 和 FLCr 浓度明显高于非 PCNSL 患者（P<0.05）。FLCr 的最佳截断值为 0.35，诊断的敏感性和特异性分别为 78%和 72%。化疗后 FLCr 浓度降低。
CSF FLC 是诊断和监测 PCNSL 化疗效果的一种新型生物标志物。
