背景:玻璃体视网膜淋巴瘤(VRL)的早期诊断对于成功治疗这种罕见的眼内恶性肿瘤至关重要。然而,在出现中度或后部非感染性葡萄膜炎的患者中,快速可靠地诊断VRL仍然是一个挑战.增殖诱导配体(APRIL)和B细胞活化因子(BAFF)是病理生理学中的重要因子。诊断,原发性中枢神经系统淋巴瘤(PCNSL)和系统性自身免疫性疾病的预后。然而,它们作为VRL和葡萄膜炎诊断的生物标志物的效用尚不清楚.
方法:在这项回顾性研究中,我们分析了40例患者的43只眼房水(AH)中的APRIL和BAFF水平,包括20例VRL患者的23只眼,八个葡萄膜炎患者的八只眼睛,和12例其他眼部疾病(OOD)患者的12只眼。此外,我们测量了5例VRL患者的5只眼睛在化疗诱导后的水平.
结果:APRIL的AH水平可靠地将VRL与葡萄膜炎区分开,特异性为78.3%,敏感性为75%。BAFF也显示出类似的潜力。化疗期间VRL患者的连续AH分析表明,APRIL和BAFF的AH水平相应下降。
结论:本研究扩展了VRL和葡萄膜炎的有价值的诊断生物标志物的范围。葡萄膜炎患者,AHAPRIL的评估可能有助于加速VRL的诊断.此外,我们的结果强调了APRIL和BAFF在VRL治疗监测中的重要作用.
BACKGROUND: Early diagnosis of vitreoretinal lymphoma (VRL) is critical for the successful treatment of this rare intraocular malignancy. However, fast and reliable diagnosis of VRL in patients presenting with intermediate or posterior non-infectious uveitis remains a challenge. A proliferation-inducing ligand (
APRIL) and B-cell activating factor (BAFF) are vital factors in the pathophysiology, diagnosis, and prognosis of primary central nervous system lymphoma (PCNSL) and systemic autoimmune diseases. However, their utility as biomarkers for the diagnosis of VRL and uveitis remains unclear.
METHODS: In this retrospective study, we analyzed
APRIL and BAFF levels in the aqueous humor (AH) of 43 eyes of 40 patients, including 23 eyes of 20 patients with VRL, eight eyes of eight patients with uveitis, and 12 eyes of 12 patients with other ocular diseases (OODs). Additionally, we measured their levels after induction of chemotherapy in five eyes of five patients with VRL.
RESULTS: AH levels of
APRIL reliably distinguished VRL from uveitis, with a specificity of 78.3% and sensitivity of 75%. BAFF also showed similar potential. Serial AH analysis of patients with VRL during chemotherapy demonstrated a corresponding decline in AH levels of APRIL and BAFF.
CONCLUSIONS: This study extends the spectrum of valuable diagnostic biomarkers for VRL and uveitis. In patients with uveitis, the assessment of AH
APRIL may help accelerate the diagnosis of VRL. Moreover, our results underline the important role of
APRIL and BAFF in therapeutic monitoring of VRL.