Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China.
Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Clin Chim Acta. 2022 Oct 1;535:1-6. doi: 10.1016/j.cca.2022.06.014. Epub 2022 Jul 9.
Early diagnosis of vitreoretinal lymphoma (VRL) is critical for the successful treatment of this rare intraocular malignancy. However, fast and reliable diagnosis of VRL in patients presenting with intermediate or posterior non-infectious uveitis remains a challenge. A proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) are vital factors in the pathophysiology, diagnosis, and prognosis of primary central nervous system lymphoma (PCNSL) and systemic autoimmune diseases. However, their utility as biomarkers for the diagnosis of VRL and uveitis remains unclear.
In this retrospective study, we analyzed APRIL and BAFF levels in the aqueous humor (AH) of 43 eyes of 40 patients, including 23 eyes of 20 patients with VRL, eight eyes of eight patients with uveitis, and 12 eyes of 12 patients with other ocular diseases (OODs). Additionally, we measured their levels after induction of chemotherapy in five eyes of five patients with VRL.
AH levels of APRIL reliably distinguished VRL from uveitis, with a specificity of 78.3% and sensitivity of 75%. BAFF also showed similar potential. Serial AH analysis of patients with VRL during chemotherapy demonstrated a corresponding decline in AH levels of APRIL and BAFF.
This study extends the spectrum of valuable diagnostic biomarkers for VRL and uveitis. In patients with uveitis, the assessment of AH APRIL may help accelerate the diagnosis of VRL. Moreover, our results underline the important role of APRIL and BAFF in therapeutic monitoring of VRL.
早期诊断眼内淋巴瘤（VRL）对于成功治疗这种罕见的眼内恶性肿瘤至关重要。然而，对于表现为中间或后部非感染性葡萄膜炎的患者，快速可靠地诊断 VRL 仍然是一个挑战。增殖诱导配体（APRIL）和 B 细胞激活因子（BAFF）是原发性中枢神经系统淋巴瘤（PCNSL）和系统性自身免疫性疾病的病理生理学、诊断和预后的重要因素。然而，它们作为 VRL 和葡萄膜炎诊断的生物标志物的效用尚不清楚。
在这项回顾性研究中，我们分析了 40 名患者的 43 只眼中的房水（AH）中的 APRIL 和 BAFF 水平，其中包括 23 只 VRL 患者的 20 只眼睛，8 只葡萄膜炎患者的 8 只眼睛，以及 12 只其他眼部疾病（OOD）患者的 12 只眼睛。此外，我们还测量了 5 例 VRL 患者经诱导化疗后 5 只眼中的 APRIL 和 BAFF 水平。
AH 水平的 APRIL 可以可靠地区分 VRL 与葡萄膜炎，特异性为 78.3%，敏感性为 75%。BAFF 也显示出类似的潜力。在化疗期间对 VRL 患者进行连续 AH 分析表明，APRIL 和 BAFF 的 AH 水平相应下降。
这项研究扩展了 VRL 和葡萄膜炎有价值的诊断生物标志物的范围。在葡萄膜炎患者中，评估 AH APRIL 可能有助于加速 VRL 的诊断。此外，我们的结果强调了 APRIL 和 BAFF 在 VRL 治疗监测中的重要作用。
