CSF and clinical data are useful in differentiating CNS inflammatory demyelinating disease from CNS lymphoma.
BACKGROUND
It is often difficult to diagnose central nervous system (CNS) inflammatory demyelinating diseases (IDDs) because they are similar to CNS lymphoma and glioma.


OBJECTIVE
To evaluate whether cerebrospinal fluid (CSF) analysis can differentiate CNS IDDs from CNS lymphoma and glioma.


METHODS
We measured CSF cell counts; concentrations of proteins, glucose, interleukin (IL)-6, IL-10, soluble IL-2 receptor (sIL-2R), and myelin basic protein; and IgG index in patients with multiple sclerosis (MS, n = 64), neuromyelitis optica spectrum disorder (NMOSD, n = 35), tumefactive demyelinating lesion (TDL, n = 17), CNS lymphoma ( n = 12), or glioma ( n = 10). We detected diagnostic markers using logistic regression and receiver operating characteristic (ROC) analyses.


RESULTS
Median CSF IL-10 and sIL-2R levels were higher in CNS lymphoma patients than in MS, NMOSD, or TDL patients. Logistic regression revealed that CSF sIL-2R levels predicted CNS lymphoma. In the ROC analysis of CSF sIL-2R levels, the area under the curve was 0.867, and the sensitivity and specificity were 83.3% and 90.0%, respectively.


CONCLUSION
CSF sIL-2R levels can be used to differentiate CNS lymphoma from CNS IDDs. Further studies may identify other applications of CSF as a diagnostic biomarker.
['Ikeguchi|Ryotaro|R|', 'Shimizu|Yuko|Y|', 'Shimizu|Satoru|S|', 'Kitagawa|Kazuo|K|']
D000328:Adult D000368:Aged D015415:Biomarkers D016543:Central Nervous System Neoplasms D020278:Demyelinating Autoimmune Diseases, CNS D003937:Diagnosis, Differential D005260:Female D006801:Humans D008223:Lymphoma D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D015375:Receptors, Interleukin-2 D012189:Retrospective Studies
cerebrospinal fluid multiple sclerosis neuromyelitis optica spectrum disorder tumefactive demyelinating lesion Central nervous system lymphoma interleukin-10 soluble interleukin-2 receptor