Villanueva-Castro Eliezer, Flores-Vázquez José Guillermo, Hernández Reséndiz Rebeca, Rodríguez-Hernández Luis A, Rodríguez-Hernández Ivan Abdiel, Villalobos-Díaz Rodolfo, Moncada-Habib Tomas, Muñuzuri-Camacho Marco Antonio, Mateo-Nouel Edgardo de Jesús, Wong-Achi Xavier, Palacios-Rodríguez Ricardo Alberto, Cacho-Díaz Bernardo, Gutierrez-Aceves Guillermo Axayacalt, Moreno-Jiménez Sergio, González-Aguilar Alberto
Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Neurology, Hospital Angeles Universidad, Mexico City, MEX.
Cureus. 2025 Jul 30;17(7):e89063. doi: 10.7759/cureus.89063. eCollection 2025 Jul.
Primary central nervous system lymphoma (PCNSL) remains a diagnostic challenge due to its radiological overlap with other brain lesions and limitations of stereotactic biopsy, particularly following corticosteroid exposure. Interleukin-10 (IL-10) is a cytokine frequently elevated in PCNSL and has emerged as a potential diagnostic biomarker, yet reported cut-off values vary widely, limiting clinical application.
To determine the diagnostic accuracy of CSF IL-10 for differentiating PCNSL from other brain lesions by estimating the optimal cut-off, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC), and to explore its potential prognostic value.
We conducted a retrospective observational study of 115 patients who underwent lumbar puncture for diagnostic workup of brain lesions at a tertiary referral center between 2015 and 2020. CSF IL-10 levels were measured using a standardized enzyme-linked immunosorbent assay (ELISA) protocol. Patients with prior corticosteroid use, HIV infection, insufficient CSF, or lacking a definitive diagnosis were excluded. Diagnostic performance was assessed via ROC analysis. The association between CSF IL-10 and progression-free survival (PFS) was explored in patients with histologically confirmed PCNSL receiving standard therapy.
Sixty-three patients were diagnosed with PCNSL, and 52 with alternative pathologies, including gliomas, demyelinating diseases, and infections. The mean CSF IL-10 level was significantly higher in PCNSL patients (109.9 pg/mL) compared to non-PCNSL (12.6 pg/mL). Using a cut-off of 20.05 pg/mL, CSF IL-10 showed a sensitivity of 93.7% (95% CI: 84.8-97.5%) and specificity of 88.5% (95% CI: 77.0-94.6%), with an AUC of 0.95 (95% CI: 0.91-0.99). The positive predictive value was 90.8% and the negative predictive value was 92.0%. Higher IL-10 levels were modestly correlated with shorter PFS (R = 0.315, p < 0.015).
CSF IL-10 quantification may serve as a minimally invasive, high-yield adjunct in the diagnosis of PCNSL, particularly when biopsy is delayed or contraindicated. However, as both the diagnostic cut-off and prognostic correlation were derived from the same retrospective cohort, prospective validation is essential prior to clinical adoption.
原发性中枢神经系统淋巴瘤（PCNSL）因其在影像学上与其他脑病变存在重叠，且立体定向活检存在局限性，尤其是在使用皮质类固醇后，仍然是一个诊断难题。白细胞介素-10（IL-10）是一种在PCNSL中经常升高的细胞因子，已成为一种潜在的诊断生物标志物，但报告的临界值差异很大，限制了其临床应用。
通过估计最佳临界值、敏感性、特异性和受试者操作特征（ROC）曲线下面积（AUC），确定脑脊液IL-10区分PCNSL与其他脑病变的诊断准确性，并探讨其潜在的预后价值。
我们对2015年至2020年期间在一家三级转诊中心因脑病变诊断性检查而接受腰椎穿刺的115例患者进行了一项回顾性观察研究。使用标准化酶联免疫吸附测定（ELISA）方案测量脑脊液IL-10水平。排除既往使用过皮质类固醇、感染艾滋病毒、脑脊液不足或缺乏明确诊断的患者。通过ROC分析评估诊断性能。在接受标准治疗的组织学确诊PCNSL患者中，探讨脑脊液IL-10与无进展生存期（PFS）之间的关联。
63例患者被诊断为PCNSL，52例患有其他病变，包括胶质瘤、脱髓鞘疾病和感染。PCNSL患者的脑脊液IL-10平均水平（109.9 pg/mL）显著高于非PCNSL患者（12.6 pg/mL）。以20.05 pg/mL为临界值，脑脊液IL-10的敏感性为93.7%（95%CI：84.8 - 97.5%），特异性为88.5%（95%CI：77.0 - 94.6%），AUC为0.95（95%CI：0.91 - 0.99）。阳性预测值为90.8%，阴性预测值为92.0%。较高的IL-10水平与较短的PFS有适度相关性（R = 0.315，p < 0.015）。
脑脊液IL-10定量检测可作为PCNSL诊断中的一种微创、高效的辅助手段，特别是在活检延迟或禁忌时。然而，由于诊断临界值和预后相关性均来自同一回顾性队列，在临床应用前进行前瞻性验证至关重要。
