目的:探讨原发性中枢神经系统淋巴瘤（PCNSL）患者脑脊液的实验室检测指标在PCNSL诊断及鉴别诊断中的价值。方法:2017年12月至2020年1月在北京天坛医院诊断PCNSL的46例患者作为研究对象，选取同期就诊的中枢神经系统脱髓鞘疾病44例、中枢神经系统感染性疾病37例作为对照组，进行回顾性分析。比较3组患者的脑脊液细胞学、脑脊液有核细胞数、脑脊液糖、蛋白、氯及脑脊液细胞因子肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、IL-8、IL-10、IL-10/IL-6各指标表达水平，采用n F检验或秩和检验比较组间水平差异，对有统计学意义的指标采用受试者工作特征（ROC）曲线评价指标的诊断价值。n 结果:46例PCNSL患者中有15例在脑脊液中发现淋巴瘤细胞（32.6%）；淋巴瘤组脑脊液蛋白［53.11（37.20， 82.8） g/L］和脑脊液TNF-α［9.10（6.20，12.55）ng/L］明显高于脱髓鞘组［脑脊液蛋白：35.09（25.71， 56.33） g/L和脑脊液TNF-α：4.91（4.00，7.64）ng/L］，差异有统计学意义（n P均<0.05）。诊断PCNSL的ROC曲线下面积分别为0.630和0.631（n P<0.05）；PCNSL组脑脊液IL-10［5.08（5.00，29.23）ng/L］和IL-10/IL-6［1.97（1.14，5.20）］高于脱髓鞘组［IL-10∶5.00（5.00，5.00）ng/L；IL-10/IL-6∶1.11（0.84，1.95）］及脑膜炎组［IL-10∶5.00（5.00，6.58）ng/L；IL-10/IL-6∶1.64（0.33，1.64）］，差异有统计学意义（n P均<0.05）。诊断PCNSL的ROC曲线下面积分别为0.729和0.735（n P<0.05）；当IL-10的临界值选择8.47时，敏感度为48.9%，特异度为95.6%，但IL-10/IL-6的临界值选择1.38时，敏感度为73.3%，特异度为64.8%。n 结论:脑脊液中发现淋巴瘤细胞是PCNSL的诊断的直接依据，脑脊液细胞因子IL-10及IL-10/IL-6对PCNSL有较高的诊断价值。“,”Objective:To evaluate the value of laboratory tests of cerebrospinal fluid in the diagnosis and differential diagnosis of primary central nervous system lymphoma (PCNSL).Methods:46 patients diagnosed with PCNSL in Beijing Tiantan Hospital from December 2017 to January 2020 were selected as subjects of study, and 44 patients with demyelinating diseases of the central nervous system and 37 patients with infectious diseases of the central nervous system were selected as control groups. Laboratory tests of cerebrospinal fluid including cytology, nucleated cells, sugar, protein,chlorine and cytokines TNF-α,IL-6,IL-8 and IL-10 were retrospectively analyzed and compared in three groups. F test or rank sum test were used to analyze the differences between groups,and the statistical significance of diagnostic value of the indicators was evaluated by receiver operating characteristic curve (ROC).Results:Lymphoma cells were found in CSF in 15 of the 46 PCNSL patients (32.6%). CSF protein (53.11 [37.20, 82.8] g/L) and CSF TNF-α (9.10 [6.20,12.55]ng/L) in PCNSL group were significantly higher than those in the central nervous system demyelination group (CSF protein:35.09 [25.71, 56.33] g/L;CSF TNF-α:4.91 [4.00,7.64]ng/L), and the AUC of the two indexes for diagnosis of PCNSL was 0.630 and 0.631 respectively (n P<0.05). In the PCNSL group, cerebrospinal fluid IL-10 (5.08 [5.00,29.23]ng/L) and IL-10/IL-6 (1.97 [1.14,5.20]) were higher than those in the CNS demyelination disease group (IL-10:5.00 [5.00,5.00]ng/L;IL-10/IL-6:1.11 [0.84,1.95]) and the CNS infectious disease group (IL-10:5.00 [5.00,6.58]ng/L;IL-10/IL-6:1.64 [0.33,1.64]). The AUC of the two indexes for diagnosis of PCNSL was 0.729 and 0.735 (n P<0.05). When the cut-off value of IL-10 is 8.47, the sensitivity and specificity are 48.9% and 95.6% respectively, and when the cut-off value of IL-10/IL-6 is 1.38, the sensitivity and specificity are 73.3% and 64.8% respectively.n Conclusion:The presence of lymphoma cells in CSF is the direct basis for the diagnosis of PCNSL and CSF cytokines IL-10 and IL-10/IL-6 have high diagnostic value for PCNSL.