Clinical Significance of Cerebrospinal Fluid IL-10 in Primary Central Nervous System Lymphoma: A Systematic Review With Meta-analysis
Ivan Alegre-Cordero1, Gerardo Luna-Peralta2, Arturo Jhonny Ruiz Yaringano1, Bryan Sulca1, Freddy Arcos Rivera1, GABRIEL ELGUERA ROJAS1, Miguel Cabanillas Lazo3, Carlos Quispe Vicuña3
1Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú, 2Universidad Nacional Mayor de San Marcos, Lima, Perú, 3Grupo de Investigación NEMECS: Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria, Universidad Científica del Sur, Lima, Perú.
Objective:
To summarize the current evidence on the clinical significance of interleukin-10 (IL-10) in cerebrospinal fluid (CSF) on Primary central nervous system lymphoma (PCNSL).
Background:
PCNSL is a rare, aggressive lymphoma localized mainly in the brain, and spinal cord. IL-10 contributes to PCNSL pathogenesis by modulating immune activity and shaping the tumor microenvironment, positioning CSF IL-10 as a potential biomarker for diagnosis, disease monitoring and differentiation from other CNS tumors.
Design/Methods:
A systematic search of PubMed, Embase, Scopus, Web of Science, and Google Scholar up to August 2025 identified observational studies evaluating CSF IL-10 in PCNSL. Pooled sensitivity, specificity, and SROC area were calculated. Random-effects meta-analyses and sensitivity were conducted, with narrative synthesis applied when meta-analysis was not feasible. Subgroup analyses compared PCNSL with other CNS diseases, and study quality was evaluated using the Newcastle–Ottawa Scale.
Results:
Twelve studies (1205 participants) met inclusion criteria. Compared with a broad range of CNS diseases, IL-10 showed pooled sensitivity and specificity of 89.2% (95% CI, 52.1–98.4% and 48.6–98.6%, respectively) and AUC of 0.951 (95% CI, 0.872–0.998). Compared with other CNS tumors, sensitivity and specificity were 90.7% (95% CI, 46.0–99.1%) and 90.7% (95% CI, 32.3–99.5%), respectively, with an AUC of 0.962 (95% CI, 0.29–0.99). CSF IL-10 levels were significantly higher in PCNSL than systemic non-Hodgkin lymphoma (SMD 1.89; 2 studies; 111 participants; 95% CI, 1.03–2.74; I² = 69.3%) and in PCNSL with CSF involvement (SMD 2.35; 3 studies; 472 participants; 95% CI, 0.82–3.88; I² = 94.9%). All studies demonstrated low risk of bias.
Conclusions:
CSF IL-10 exhibits high diagnostic accuracy for PCNSL. Nevertheless, the wide confidence intervals reflect heterogeneity across studies, likely due to differences in cut-off values, study populations, and comparator conditions. Despite this variability, the consistently elevated IL-10 levels observed in PCNSL are promising, supporting its potential as a reliable biomarker for diagnosis and disease monitoring.
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