脑脊髓液中白介素 6 和白介素 10 作为二级中枢神经系统淋巴瘤有前途的诊断和治疗预后生物标志物。

Cerebrospinal fluid IL-6 and IL-10 as promising diagnostic and therapeutic prognostic biomarkers for secondary central nervous system lymphoma.

机构信息

Institute of Hematology, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 qingchun road, Hangzhou, 310003, China.

Key Laboratory of Hematologic Malignancies, Diagnosis and Treatment, Hangzhou, Zhejiang Province, 310003, China.

出版信息

BMC Cancer. 2024 Nov 22;24(1):1443. doi: 10.1186/s12885-024-13195-5.

BACKGROUND

Accurate diagnosis and therapeutic response to secondary central nervous system lymphoma (SCNSL) are challenges that need to be addressed. We assessed the value of cerebrospinal fluid (CSF) cytokine levels for diagnosis and post-therapeutic prognosis in patients with SCNSL.

METHODS

This retrospective study included 234 patients with non-Hodgkin lymphoma (NHL), including the SCNSL group (n = 57) and the non-SCNSL group (n = 177). The Mann-Whitney U test was used to compare the cytokine profiles between SCNSL and non-SCNSL group. Receiver operating characteristic curve was used to determine the diagnostic ability of CSF cytokine levels for SCNSL. The predictive value of CSF cytokine concentrations for progression free survival of patients with SCNSL was evaluated using a log-rank test.

RESULTS

CSF IL-6 and IL-10 levels in SCNSL group were significantly elevated compared with those in the other two groups. ROC curve showed that the cutoff values of IL-6 and IL-10 in CSF were 10.13 pg/ml and 7.82pg/ml, which yielded the diagnostic sensitivity were 62.34% and 76.23%, specificity were 87.57% and 88.31%, respectively. Furthermore, combining CSF IL-6 and IL-10 levels significantly improved the diagnostic efficacy. CSF IL-6 and IL-10 levels in SCNSL patients in complete remission under chemotherapy were significantly reduced. In addition, poor progression free survival (PFS) in patients with SCNSL was related to increased CSF IL-10 levels at diagnosis, but not with increased CSF IL-6 levels.

CONCLUSION

CSF IL-6 and IL-10 levels are promising biomarkers for diagnosis and predictors of response for SCNSL.

背景

准确诊断和治疗反应继发中枢神经系统淋巴瘤（SCNSL）是需要解决的挑战。我们评估了脑脊液（CSF）细胞因子水平对 SCNSL 患者诊断和治疗后预后的价值。

方法

这项回顾性研究纳入了 234 例非霍奇金淋巴瘤（NHL）患者，包括 SCNSL 组（n=57）和非 SCNSL 组（n=177）。采用 Mann-Whitney U 检验比较 SCNSL 组与非 SCNSL 组的细胞因子谱。采用受试者工作特征曲线（ROC 曲线）确定 CSF 细胞因子水平对 SCNSL 的诊断能力。采用对数秩检验评估 CSF 细胞因子浓度对 SCNSL 患者无进展生存的预测价值。

结果

与另外两组相比，SCNSL 组 CSF IL-6 和 IL-10 水平明显升高。ROC 曲线显示 CSF 中 IL-6 和 IL-10 的截断值分别为 10.13pg/ml 和 7.82pg/ml，诊断灵敏度分别为 62.34%和 76.23%，特异性分别为 87.57%和 88.31%。此外，联合 CSF IL-6 和 IL-10 水平显著提高了诊断效能。化疗后完全缓解的 SCNSL 患者 CSF IL-6 和 IL-10 水平显著降低。此外，SCNSL 患者无进展生存（PFS）较差与诊断时 CSF IL-10 水平升高有关，而与 CSF IL-6 水平升高无关。