IL-10/6, MYD88 show diagnostic accuracy for primary vitreoretinal lymphoma
6 hours ago
Parallel testing of interleukin (IL)-10 to IL-6 and MYD88 demonstrates the highest diagnostic performance among strategies evaluated for primary vitreoretinal lymphoma (PVRL), suggests a study.
However, this finding warrants prospective validation due to the low to very low certainty of the underlying evidence, according to the researchers.
Forty-one studies, including a total of 2,411 patients with confirmed PVRL or benign ocular inflammatory diseases, were included in this systematic review and meta-analysis. The research team assessed the methodologic quality using QUADAS-2 and Comparative tools. They also pooled the diagnostic accuracy using hierarchical summary receiver operating characteristic (HSROC) models.
Most of the included studies had high or unclear risk of bias across Quality Assessment of Diagnostic Accuracy Studies 2 domains, particularly in patient selection due to the retrospective designs and nonconsecutive sampling, and in the index test domain due to post hoc threshold selection.
The IL-10 to IL-6 ratio (27 studies; 1,370 patients; AUSROC, 0.98; sensitivity, 0.89; specificity, 0.98, I2, 61 percent and 69 percent, respectively; low certainty) exhibited no publication bias.
Statistically, MYD88 (12 studies; 382 patients; AUSROC, 0.89; sensitivity, 0.73, specificity, 0.99; I2, 37 percent and 68 percent, respectively; very low certainty), IGH (12 studies; 649 patients; AUSROC, 0.97; sensitivity, 0.85, specificity, 0.97; I2, 80 percent and 87 percent, respectively; very low certainty), and IL-10 alone (11 studies; 549 patients; AUSROC, 0.94; sensitivity, 0.87, specificity, 0.95; I2, 58 percent and 84 percent, respectively; low certainty) were not superior to IL-10 and IL-6.
On the other hand, CD79B (four studies; 123 patients; AUSROC, 1.00; sensitivity, 0.40; specificity, 1.00; I2, 35 percent and 0 percent, respectively; low certainty) displayed numerically greater accuracy (p=0.055).
In parallel testing of IL-10 to IL-6 and MYD88, sensitivity was 97.1 percent and specificity was 97.0 percent, reducing false-negative rates from 11 percent to 2.9 percent.
“Aqueous humor cytokine testing yielded higher diagnostic odds ratios than vitreous fluid, suggesting anterior paracentesis for IL-10 to IL-6 ratio before vitreous biopsy for molecular confirmation,” the researchers said.