原发中枢神经系统淋巴瘤患者脑脊液生物标记物检测的临床意义研究进展

Research progress on biomarkers in the cerebrospinal fluid of primary central nervous system lymphoma patients for the clinical significance

原发性中枢神经系统淋巴瘤（primary central nervous system lymphoma,PCNSL）是指患者诊断时肿瘤局限于大脑、小脑、脑干、眼、软脑膜和脊髓等中枢神经系统（CNS）部位,尚未发现累及CNS以外部位的淋巴瘤。PCNSL是非霍奇金淋巴瘤（non-Hodgkin＇s lymphoma,NHL）的一个罕见类型,主要为B细胞起源,其发病机制尚未明确。

Primary central nervous system lymphoma （PCNSL） is a rare type of non-Hodgkin lymphoma and is predominantly of B cell origin. PCNSL is currently diagnosed by performing a histological examination of a brain biopsy specimen. It＇s vital to find an effective way to diagnosis at an early stage since PCNSL is aggressive and has a poor prognosis. Recent researches have shown that biomarkers in the cerebrospinal fluid （CSF） of PCNSL patients are promising. EBV-DNA in the CSF has been recognized as an optimal marker for HIV-positive PCNSL and it has been a routine detection index now for HIV-positive patients with focal brain lesions. According to recent studies,microRNAs,IL-10 and CXCL13 are also potential proper biomarkers for PCNSL on the basis of their sensitivity and specificity,especially for IL-10 plus CXCL13 ,but researches of larger sample size are needed. Additionally,the λ/κ FLC ratio in the CSF appears to be a promising parameter in PCNSL comparing with λ or κ FLC alone. Combined soluble CD27 with routine CSF indexes are also useful in the diagnosis. Moreover, the role of antithrombin Ⅲ is still controversial and need to be further studied.