Whitcup S M, Stark-Vancs V, Wittes R E, Solomon D, Podgor M J, Nussenblatt R B, Chan C C
National Eye Institute, National Institutes of Health, Bethesda, Md., USA.
Arch Ophthalmol. 1997 Sep;115(9):1157-60. doi: 10.1001/archopht.1997.01100160327010.
Diagnosis of primary central nervous system lymphoma (PCNSL) is usually made by identifying malignant lymphocytes in the brain, cerebrospinal fluid (CSF), or vitreous. However, these cells are few and friable, and misdiagnosis can occur, even in properly prepared specimens. Recent data suggest that levels of interleukin 10 (IL-10) are elevated in the serum and vitreous of patients with non-Hodgkin lymphoma; levels of interleukin 6 (IL-6) are elevated in the vitreous of patients with intraocular inflammation unrelated to a malignant neoplasm. We investigated whether PCNSL involving the vitreous or CSF is associated with elevated ratios of IL-10 to IL-6.
Vitreous specimens were obtained from 5 patients with PCNSL involving the eye and from 13 control patients with intraocular inflammation not related to a malignant neoplasm; CSF specimens were obtained from 11 patients with PCNSL.
Levels of IL-10 exceeded those of IL-6 in all 5 patients with intraocular lymphoma but in none of the 13 patients with uveitis (P < .001). In patients with PCNSL, levels of IL-10 exceeded those of IL-6 in 6 of 11 CSF samples with malignant cells compared with 7 of 53 samples without malignant cells (P = .01). The calculated odds ratio (OR) suggests that the risk for malignant involvement of the CSF is about 8 times higher when IL-10 levels exceed IL-6 levels.
Levels of IL-10 and IL-6 were determined by enzyme-linked immunosorbent assay in both vitreous and CSF specimens.
The occurrence of PCNSL in the eye was strongly associated with elevated vitreous levels of IL-10 relative to levels of IL-6. Moreover, among patients with diagnosed PCNSL, malignant cells were significantly more likely to be present in CSF when levels of IL-10 exceeded those of IL-6.
原发性中枢神经系统淋巴瘤（PCNSL）的诊断通常是通过在脑、脑脊液（CSF）或玻璃体中识别恶性淋巴细胞来进行。然而，这些细胞数量稀少且脆弱，即使在制备得当的标本中也可能发生误诊。最近的数据表明，非霍奇金淋巴瘤患者的血清和玻璃体中白细胞介素10（IL-10）水平升高；与恶性肿瘤无关的眼内炎症患者的玻璃体中白细胞介素6（IL-6）水平升高。我们研究了累及玻璃体或脑脊液的PCNSL是否与IL-10与IL-6的比率升高有关。
从5例累及眼部的PCNSL患者和13例与恶性肿瘤无关的眼内炎症对照患者中获取玻璃体标本；从11例PCNSL患者中获取脑脊液标本。
所有5例眼内淋巴瘤患者的IL-10水平均超过IL-6水平，但13例葡萄膜炎患者中无一例如此（P <.001）。在PCNSL患者中，11份含有恶性细胞的脑脊液样本中有6份IL-10水平超过IL-6水平，而53份无恶性细胞的样本中有7份如此（P =.01）。计算出的优势比（OR）表明，当IL-10水平超过IL-6水平时，脑脊液发生恶性累及的风险大约高8倍。
通过酶联免疫吸附测定法测定玻璃体和脑脊液标本中IL-10和IL-6的水平。
眼部PCNSL的发生与玻璃体中IL-10水平相对于IL-6水平升高密切相关。此外，在已确诊的PCNSL患者中，当IL-10水平超过IL-6水平时，脑脊液中更有可能存在恶性细胞。
