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脑脊液 sLR11 和 sIL-2R 对恶性中枢神经系统淋巴瘤的诊断价值。

Diagnostic Value of sLR11 and sIL-2R in the Cerebrospinal Fluid for Malignant Central Nervous System Lymphoma.

机构信息

Department of Hematology, Toho University Sakura Medical Center, Japan.

Department of Blood Transfusion, Toho University Sakura Medical Center, Japan.

出版信息

Intern Med. 2024 Oct 15;63(20):2767-2771. doi: 10.2169/internalmedicine.3325-23. Epub 2024 Mar 4.

Abstract

Objective We previously reported that patients with acute leukemia and malignant lymphoma (ML) demonstrated significantly increased serum soluble LR11 (sLR11) levels compared to normal controls. Accurately diagnosing ML of the central nervous system (CNS ML) using cytology is frequently difficult. Therefore, we evaluated the use of cerebrospinal fluid (CSF) sLR11 and soluble interleukin-2 receptor (sIL-2R) as diagnostic and treatment response markers for CNS ML. Methods We retrospectively evaluated the CSF results for CNS ML using clinical data at our institution, and then analyzed the usefulness of sLR11 and sIL-2R in CSF for both the diagnosis and as surrogate markers that reflect the therapeutic effect. Patients We enrolled patients with CNS ML who received intrathecal anticancer drugs between 2017 and 2023. We analyzed the sLR11 and sIL-2R levels in CSF and cytological malignant grades. We studied 22 patients, including 17 with central nervous system (CNS) clinical conditions and five who received prevention treatment. Results The CSF sLR11 levels were significantly and positively correlated with CSF sIL-2R levels. The CSF sLR11 and sIL-2R levels in patients with CNS ML were significantly higher than those in the prevention group. A receiver operating characteristic (ROC) curve analysis showed the cut-off value of sLR11 for CNS invasion to be 21.7 ng/mL. Moreover, the chemotherapy-responder group demonstrated significantly decreased CSF sLR11 and sIL-2R levels after treatment. Conclusion CSF sLR11 and sIL-2R of CSF were found to be useful biomarkers for the diagnostic and treatment response evaluation in patients with CNS ML.

摘要

目的 我们之前报道称,与正常对照组相比,急性白血病和恶性淋巴瘤(ML)患者的血清可溶性 LR11(sLR11)水平显著升高。使用细胞学准确诊断中枢神经系统(CNS)ML 时常有困难。因此,我们评估了脑脊液(CSF)sLR11 和可溶性白细胞介素 2 受体(sIL-2R)作为 CNS ML 的诊断和治疗反应标志物的用途。

方法 我们回顾性地评估了我们机构的临床数据中 CNS ML 的 CSF 结果,然后分析了 CSF 中 sLR11 和 sIL-2R 在诊断和反映治疗效果的替代标志物方面的有用性。

患者 我们纳入了 2017 年至 2023 年期间接受鞘内抗癌药物治疗的 CNS ML 患者。我们分析了 CSF 中 sLR11 和 sIL-2R 水平以及细胞学恶性程度。我们研究了 22 例患者,包括 17 例中枢神经系统(CNS)临床患者和 5 例预防治疗患者。

结果 CSF sLR11 水平与 CSF sIL-2R 水平呈显著正相关。CNS ML 患者的 CSF sLR11 和 sIL-2R 水平明显高于预防组。ROC 曲线分析显示,sLR11 用于 CNS 侵袭的截断值为 21.7ng/ml。此外,化疗反应组在治疗后 CSF sLR11 和 sIL-2R 水平显著降低。

结论 CSF sLR11 和 sIL-2R 可作为 CNS ML 患者诊断和治疗反应评估的有用生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f464/11557189/316a544a320c/1349-7235-63-2767-g001.jpg

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