SynthesisJournal of molecular medicine (Berlin, Germany)2026
Clinical utility of cerebrospinal fluid interleukin-10 in central nervous system lymphoma: a molecular neuropathology-informed diagnostic meta-analysis.
Synthesis in Journal of molecular medicine (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Accurate diagnosis of central nervous system lymphoma (CNSL) remains challenging, and cerebrospinal fluid (CSF) interleukin-10 (IL-10) has emerged as a promising minimally invasive biomarker. We conducted a PRISMA-DTA systematic review and diagnostic meta-analysis to evaluate the diagnostic performance of CSF IL-10 for CNSL and to examine its clinical utility and robustness using a reproducible Python-based workflow. Eleven studies comprising 1,462 participants (510 CNSL cases and 952 controls) met the inclusion criteria. Using a bivariate random-effects model, the pooled sensitivity and specificity were 79.8% (95% CI, 76.1-83.2) and 94.8% (95% CI, 93.2-96.0), respectively. The pooled positive likelihood ratio was 18.04 (95% CI, 8.35-38.98), the negative likelihood ratio was 0.185 (95% CI, 0.118-0.291), and the diagnostic odds ratio was 130.55 (95% CI, 47.85-356.14). The summary receiver operating characteristic curve demonstrated excellent overall accuracy, with an area under the curve of 0.973 and a Q* index of 0.9246. Leave-one-out sensitivity analysis showed only modest changes in the pooled estimates, supporting the stability of the results. Δ-sensitivity ranged from - 1.9% to + 3.0% and Δ-specificity from - 1.1% to + 2.0%, supporting robustness. Fagan's analysis, using a pre-test probability of 34.9%, yielded post-test probabilities of 90.6% following a positive result and 9.0% following a negative result. Publication bias was suggested by Begg's test (τ = 0.400, p = 0.0434) and Egger's test (intercept = 3.283, 95% CI, 1.337-5.229; p = 0.0021), while trim-and-fill analysis indicated potential small-study effects. Overall, CSF IL-10 demonstrates high diagnostic accuracy and strong rule-in utility for CNSL. However, prospective multicenter studies with standardized thresholds and pre-analytical protocols are needed to confirm its clinical applicability.
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