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

在过去的十年中，初级中枢神经系统(PCNSL)在免疫功能正常人群和免疫抑制人群中的数量都有所增加。虽然近年来有关获得性免疫缺陷综合征(AIDS)相关PCNSL的诊断方法有很多研究，但在免疫功能正常的人群中还没有发现可靠的PCNSL肿瘤标志物，目前准确的诊断依赖于组织病理学技术。然而，一些PCNSL患者由于生理或社会问题而不适合手术治疗，其他辅助诊断方法对于这类患者是必不可少的。因此，本研究的目的是通过分析来自PCNSL组、其他脑肿瘤(OBT)组、其他神经疾病(OND)组和炎性神经疾病(IND)组共93例脑脊液标本，探讨脑脊液sCD27作为免疫功能正常的PCNSL患者的肿瘤标志物的诊断价值。结果26例PCNSL中有23例脑脊液sCD27水平高于15U/ml，12例IND中有11例脑脊液sCD27水平高于15U/ml。而OBT组和OND组的sCD27水平均低于15U/ml。此外，两名PCNSL患者的临床病程与sCD27水平有很好的相关性。综上所述，CSFsCD27可作为免疫功能正常患者PCNSL的肿瘤标志物，也可用于评估各种治疗方法的疗效。尽管PCNSL组和IND组之间的sCD27水平存在较大的交叉反应，但脑脊液白细胞计数有助于区分这两种疾病。

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.