DIAGNOSTIC UTILITY OF CEREBROSPINAL FLUID(CSF)SOLUBLE CD27(SCD27)FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA USING ENZYME-LINKED IMMUNOSORBENT ASSAY(ELISA)

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In the last decade, primary central nervous system(PCNSL)increased in number in immunocompetent populations as well as in immunosuppressed populations. Although recently there are many studies concerning diagnostic methods of acquired immunodeficiency syndrome(AIDS)-related PCNSL, no reliable tumor marker for PCNSL has been identified yet in immunocompetent populations, and at present the precise diagnosis is dependent on the histopathological technique. However, some patients with PCNSL are not suitable for surgical intervention due to physiological or social problems, and other adjunctive diagnostic methods are essential for such patients. Therefore, the aim of our present study is to stimate the diagnostic value of CSF sCD27 as a tumor marker for PCNSL in immunocompetent patients by means of analyzing a total of 93 CSF samples obtained from the following four patient groups : the PCNSL group, the other brain tumors(OBT)group, the other neurological diseases(OND)group, and the inflammatory neurological diseases(IND)group. As a result, the CSF sCD27 levels were over 15 U/ml in 23 of 26 PCNSL samples and in 11 of 12 IND samples. In contrast, the sCD27 levels were below 15 U/ml in the OBT and OND groups. Moreover, the clinical courses and the sCD27 levels correlated very well in two PCNSL patients. Taken together, CSF sCD27 is useful as a tumor marker for PCNSL in immunocompetent patients, and is also useful to evaluate the effect of various types of treatment. Although there was a large cross-reactivity in the sCD27 levels between PCNSL and IND groups, the CSF white blood cell count is helpful to distinguish these two diseases.