Tear cytokine profiles in patients with extranodal marginal zone B-cell lymphoma of the ocular adnexa

Objectives To comprehensively analyse the tear cytokine levels of patients with extranodal marginal zone B-cell lymphoma (EMZL) of the ocular adnexa (OA), and the association with clinical characteristics. Methods Tear cytokine concentrations of 21 OA-EMZL patients and 14 age- and sex-matched healthy controls were measured using a 27-multiplex bead analysis on a Luminex system. Tear break-up time, corneal fluorescent staining and other clinical and demographic data were collected as well. The diagnosis of OA-EMZL was established based on the incisional biopsy and histopathology. Results The concentrations of interleukin-1 receptor antagonist (IL-1RA) and IL-8, and the ratio of IL-1RA/IL-1 beta were significantly increased in OA-EMZL tear samples (all P < 0.05), while the levels of three cytokines (FGF-2, IL-2 and IL-4), as well as IL-10/IL-6 ratio were significantly decreased (all P < 0.05). The American Joint Committee on Cancer Tumour stage was significantly associated with tear concentrations of FGF-2 (r = -0.44, P = 0.043), GM-CSF (r = -0.49, P = 0.025) and IL-2 (r = -0.45, P = 0.042), while lacrimal gland lymphoma invasion was related to levels of IL-8 (r = 0.53, P = 0.012), FGF-2 (r = -0.43, P = 0.049) and IL-10/IL-6 ratio (r = -0.48, P = 0.026). Receiver operating characteristic (ROC) curve analysis revealed moderate diagnostic accuracy of these indices in differentiating OA-EMZL from normal eyes (area under ROC: 0.69-0.74). Conclusions Multiple tear cytokines were significantly dysregulated in OA-EMZL patients. These cytokines could potentially serve as diagnostic biomarkers and therapeutic targets in future.