Abstract

Background
and Objective: Carcinomatous meningitis(CM) is an uncommon metastatic disease of the CNS, occuring in 1 to 5% of patients with solid cancer. It is important to make the accurate diagnosis of CM because the institution of appropriate therapy may produce symptomatic improvement, prevent neurologic deterioration and prolong survival. The purpose of this study is to suggest the effective diag- nostic method through analyzing interleukin(IL)-1β, IL-6, IL-8, IL-10, tumor necrosis factor(TNF)-α and monocyte chemoattractant protein(MCP)-1 by the cerebrospinal fluid(CSF) of CM, and to evaluate the correlation between cytokines with other chemical and tumor marker. Methods: 12 samples were evaluated by twelve patients with CM, who had diagnosed by CSF cytology or elevated tumor marker. The cytokines were measured by sandwich ELISA(enzyme linked immunosor- bent assay) method and compared the diagnostic value of each cytokines with that of other biochemical markers of CM. Results: The mean CSF concentrations of IL-8 and MCP-1 from CM were significantly higher than in the normal control group(p<0.005). IL-6 concentrations in CSF samples from patients with CM were higher than those in normal control, but not significantly different in CM group. IL-1β was positive in 2 cases and TNF-α was positive in only 1 case. IL-10 was negative in all cases. Carcinoembryonic antigen (CEA) is elevated in 9 CSF samples of CM. There was no significant relationship between cytokine levels and other diagnostic marker. Conclusion: CSF IL-6, IL-8, MCP-1 and CEA are a valuable tool in the investigation of CM, hence a rapid assay for cytokines and tumor marker in CSF may contribute to the early diagnosis of CM. Korean Journal of Headache 5(1):90-97, 2004