Role of combined determination of intraocular fluid immunophenotyping，IL-10/IL-6 ratio and MYD88 gene L265P mutation in the diagnosis of PVRL

doi:10.3969/j.issn.1673-8640.2026.08.001

Abstract

Abstract:

Objective To investigate the role of intraocular fluid flow cytometry immunophenotyping，interleukin（IL）-10/IL-6 ratio and MYD88 gene L265P mutation combined determination in the diagnosis of primary vitreoretinal lymphoma（PVRL）. Methods From January 2024 to October 2025，10 patients with PVRL（PVRL group） and 10 patients with uveitis（control group） were enrolled from Shanghai General Hospital of Shanghai Jiao Tong University School of Medicine. The clinical data were collected. The samples of intraocular fluid（vitreous fluid or aqueous humor） were collected for flow cytometry immunophenotyping，IL-10 and IL-6 levels and MYD88 gene L265P mutation determinations. The plasma levels of IL-10 and IL-6 were also determined，and the IL-10/IL-6 ratio was calculated. The efficacy of each index in diagnosing PVRL was evaluated by receiver operating characteristic（ROC） curve. Results There was statistical significance in the morphology of vitreous opacity between PVRL group and control group. In the PVRL group，4 cases（40%） were misdiagnosed as uveitis at the initial diagnosis. In the control group，8 cases had typical acute inflammatory signs without misdiagnosis. There was statistical significance in the proportion of acute inflammatory signs and the misdiagnosis rate between the 2 groups（P<0.05），while the differences in the other clinical data were not statistically significant（P>0.05）. In the PVRL group，5 cases（50%） had abnormal monoclonal B cells，and 6 cases（60%） had MYD88 gene L265P mutation. No abnormal monoclonal B cells or MYD88 gene L265P mutation was determined in the control group. The levels of intraocular fluid IL-10 and IL-10/IL-6 ratio in the PVRL group were higher than those in the control group（P<0.001），and the level of intraocular fluid IL-6 was lower in the PVRL group（P<0.001）. There was no statistical significance in the plasma levels of IL-10，IL-6 and plasma IL-10/IL-6 ratio between the 2 groups（P>0.05），and the plasma IL-10/IL-6 ratio was ≤1.0. The areas under curves（AUC） for intraocular fluid flow cytometry immunophenotyping，IL-10/IL-6 ratio and MYD88 gene L265P mutation single and combined determinations（with any positive result as positive for combined determination） in diagnosing PVRL were 0.750，0.950，0.800 and 1.000，respectively. Conclusions Intraocular fluid flow cytometry immunophenotyping，IL-10/IL-6 ratio and MYD88 gene L265P mutation combined determination can effectively diagnose PVRL.

Key words: Flow cytometry, Immunophenotyping, Interleukin-6, Interleukin-10, MYD88 gene L265P mutation, Intraocular fluid, Primary vitreoretinal lymphoma

CLC Number:

R446.1

ZHAO Jinyan, PENG Xia, LI Yaohua, ZHANG Ying, YU Wenfang. Role of combined determination of intraocular fluid immunophenotyping，IL-10/IL-6 ratio and MYD88 gene L265P mutation in the diagnosis of PVRL[J]. Laboratory Medicine, 2026, 41(8): 723-728.

Figures/Tables 5

References 20

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组别	例数		年龄/岁	性别		累及眼睛			视力下降/例
组别	例数		年龄/岁	男/例	女/例		单眼/例		双眼/例
PVRL组	10		65.0（61.25，72.25）	2	8		4		6	10
对照组	10		64.5（53.50，69.50）	6	4		8		2	10
统计值			34.000	2.133		3.333
P值			0.449	0.170		0.068			1.000
组别	玻璃体混浊特征			急性炎症体征				初诊误诊/例
组别	例数/例	混浊特征		例数/例	临床特征			初诊误诊/例
PVRL组	10	点状、泥沙样、极光样、团絮状		0	眼痛、结膜充血、前房细胞、前房积脓等			4
对照组	10	点状、絮状		8	眼痛、结膜充血、前房细胞、前房积脓等			0
统计值
P值	1.000			<0.001				0.044

组别	例数		年龄/岁	性别		累及眼睛			视力下降/例
组别	例数		年龄/岁	男/例	女/例		单眼/例		双眼/例
PVRL组	10		65.0（61.25，72.25）	2	8		4		6	10
对照组	10		64.5（53.50，69.50）	6	4		8		2	10
统计值			34.000	2.133		3.333
P值			0.449	0.170		0.068			1.000
组别	玻璃体混浊特征			急性炎症体征				初诊误诊/例
组别	例数/例	混浊特征		例数/例	临床特征			初诊误诊/例
PVRL组	10	点状、泥沙样、极光样、团絮状		0	眼痛、结膜充血、前房细胞、前房积脓等			4
对照组	10	点状、絮状		8	眼痛、结膜充血、前房细胞、前房积脓等			0
统计值
P值	1.000			<0.001				0.044

组别	例数	IL-6		IL-10		IL-10/IL-6比值
组别	例数	眼内液/ （pg·mL^-1）	血浆/（pg·mL^-1）	眼内液/ （pg·mL^-1）	血浆/（pg·mL^-1）	眼内液	血浆
PVRL组	10	83.06 （35.30，150.60）	4.25 （3.90，5.55）	1 530.65 （590.50，3 207.60）	2.44 （2.44，3.23）	15.32 （5.30，31.90）	0.61 （0.57，0.70）
对照组	10	4 132.34 （1 016.40，10 000.00）	4.20 （3.58，4.67）	47.47 （38.10，62.10）	2.44 （2.44，2.86）	0.03 （0.01，0.03）	0.68 （0.60，0.70）
U值		2.0	59.5	100.0	52.5	100.0	42.5
P值		<0.001	0.493	<0.001	0.852	<0.001	0.594

组别	例数	IL-6		IL-10		IL-10/IL-6比值
组别	例数	眼内液/ （pg·mL^-1）	血浆/（pg·mL^-1）	眼内液/ （pg·mL^-1）	血浆/（pg·mL^-1）	眼内液	血浆
PVRL组	10	83.06 （35.30，150.60）	4.25 （3.90，5.55）	1 530.65 （590.50，3 207.60）	2.44 （2.44，3.23）	15.32 （5.30，31.90）	0.61 （0.57，0.70）
对照组	10	4 132.34 （1 016.40，10 000.00）	4.20 （3.58，4.67）	47.47 （38.10，62.10）	2.44 （2.44，2.86）	0.03 （0.01，0.03）	0.68 （0.60，0.70）
U值		2.0	59.5	100.0	52.5	100.0	42.5
P值		<0.001	0.493	<0.001	0.852	<0.001	0.594

项目	真阳性/ 例	假阴性/例	真阴性/例	AUC	敏感性/%	特异性/%	阳性预测值/%	阴性预测值/%
眼内液流式细胞术免疫表型分型	5	5	10	0.750	50.0	100.0	100.0	66.7
MYD88基因L265P突变	6	4	10	0.800	60.0	100.0	100.0	71.4
眼内液IL-10/IL-6比值	9	1	10	0.950	90.0	100.0	100.0	90.9
联合检测	10	0	10	1.000	100.0	100.0	100.0	100.0