Prognostic effect of MyD88L265P gene mutation in cerebrospinal fluid in primary central nervous system lymphoma
10.3760/cma.j.cn114452-20211114-00712
- VernacularTitle:脑脊液MyD88L265P基因突变对原发性中枢神经系统淋巴瘤预后的影响
- Author:
Kun CHEN
1
;
Jingjing MA
;
Di WANG
;
Xiangyu LI
;
Huanhuan QIN
;
Zhiguang LIN
;
Yan MA
;
Bobin CHEN
;
Ming GUAN
Author Information
1. 复旦大学附属华山医院北院检验科，上海 200040
- Keywords:
Primary central nervous system lymphoma;
Cerebrospinal fluid;
Interleukin-10;
Prognosis;
Laboratory techniques and procedures
- From:
Chinese Journal of Laboratory Medicine
2022;45(1):51-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study has investigated the value of detecting cerebrospinal fluid (CSF) MyD88L265P mutation and interleukin-10 (IL-10) levels in the prognosis of PCNSL.Methods:We retrospectively analyzed the clinical data, CSF characteristics (including cytology, cell counting, total protein, and the level of cytokine IL-10) and treatment process of 39 PCNSL patients newly diagnosed by surgery and pathology (18 males and 21 females, aged 40-73 years) from August 2013 to December 2016 in Hua Shan Hospital North. MyD88L265P mutation was detected by digital PCR in 39 paraffin-embedded tissues and 35 cerebrospinal fluid samples. Log-rank test was used for univariate analysis and Cox regression for multivariate analysis to establish the prognosis model of PCNSL which might be related to PCNSL first progress-free survival (PFS) and overall survival (OS).Results:The median age of the 39 PCNSL patients was 59 years old, with 30.8% (12/39) intraocular involvement. The mutation rate of MyD88L265P in tissues and cerebrospinal fluid was 74.4% (29/39) and 40.0% (14/35), respectively. 51.9% (14/27) patients were observed with MyD88L265P mutation in both tissues and CFS. Univariate analysis showed that intraocular involvement, high level of IL-10 in CFS (≥45 pg/ml), and MyD88L265P mutation in CFS are factors significantly influencing median progression-free survival (mPFS) of patients ( P<0.05). Patients with intraocular involvement had shorter OS than those without involvement which was statistically significant ( HR=6.5,95% CI 1.7-47.3, P<0.05). And multivariate analysis showed that intraocular involvement ( HR=2.4, 95% CI 1.3-7.8, P<0.05) and CFS MyD88L265P mutation ( HR=2.1, 95% CI 1.1-5.7, P<0.05) were independent prognostic factors for PFS. Conclusion:The presence of intraocular involvement and MyD88L265P mutation in CFS indicated poor prognosis of PCNSL patients. High CSF IL-10 level was not an independent factor affecting prognosis.
