目的 探讨脑脊液（CSF）和血常规多项指标联合检测对多发性脑胶质瘤（MCG）与原发性中枢神经系统淋巴瘤（PCNSL）鉴别诊断的临床价值。 方法 回顾性分析首都医科大学附属天坛医院2017年11月至2023年3月收治的62例MCG患者和56例PCNSL患者临床资料、CSF及血常规检测指标，并分析有意义指标单独及联合应用鉴别诊断MCG与PCNSL的临床价值。 结果 MCG组CSF细胞总数、CSF白细胞数、CSF蛋白（CSF： pro）、乳酸、血常规中性粒细胞计数、中性粒细胞% 水平显著高于PCNSL组（P < 0.05）；PCNSL组CSF糖（CSF： Glu）、CSF氯（CSF： cl）、血常规淋巴细胞计数、嗜酸性粒细胞、淋巴细胞%、嗜酸性粒细胞% 水平显著高于MCG组（P < 0.05）。CSF细胞总数、CSF白细胞、CSF： pro、乳酸、血常规中性粒细胞计数、中性粒细胞% 鉴别诊断MCG和PCNSL的AUC为：0.900、0.899、0.797、0.867、0.828、0.772；灵敏度为：72.4%、77.6%、63.8%、67.2%、72.4%、82.8%；特异度为：97.1%、100.0%、88.2%、91.2%、88.2%、64.7%。此外，CSF细胞总数、CSF白细胞、CSF：pro、血常规中性粒细胞计数和中性粒细胞% 指标联合检测鉴别诊断MCG和PCNSL的AUC为0.919，敏感度和特异度为77.6%和100.0%。 结论 脑脊液学指标CSF细胞总数、CSF白细胞、CSF：pro及血常规指标中性粒细胞计数和中性粒细胞% 联合检测鉴别诊断MCG和PCNSL具有较高的临床应用价值。

Objective To investigate the clinical significance of combined cerebrospinal fluid （CSF） and routine blood parameter analysis in differentiating between multiple cerebral glioma （MCG） and primary central nervous system lymphoma （PCNSL）. Methods We Rretrospectively analyzed the clinical data， CSF and routine blood indicators levels of 62 MCG patients and 56 PCNSL patients admitted to Beijing Tiantan Hospital， Capital Medical University from November 2017 to March 2023. Additionally， we assessed the diagnostic value of individual meaningful indicators as well as their combinations in distinguishing between MCG and PCNSL. Results The levels of CSF total cell count， CSF white cell count， CSF： pro， lactate， routine bloodperipheral neutrophil count， and neutrophil percentage were significantly higher in the MCG group than in the PCNSL group （P < 0.05）； while the levels of CSF： Glu， CSF： cl， routine blood lymphocyte count， eosinophil， lymphocyte percentage， and eosinophil percentage were significantly higher in the PCNSL group than in the MCG group （P < 0.05）. The AUCs of CSF cell count， CSF white cell count， CSF： pro， lactate， routine blood neutrophil count， neutrophil percentage for differentiating MCG from PCNSL were 0.900， 0.899， 0.797， 0.867， 0.828 and 0.772 respectively； sensitivities were 72.4%， 77.6%， 63.8%， 67.2%， 72.4%， 82.8%， 77.6% and 81%， with sensitivities of 97.1%， 100%， 88.2%， 91.2%， 88.2%， 64.7%， 100% and 94.1%， respectively. In addition， the combined detection of CSF total cell count， CSF white cell count， CSF： pro， routine blood neutrophil count and neutrophil percentage in CSF had an AUC of 0.919 for differentiating MCG from PCNSL， with a sensitivity and specificity of 77.6% and 100%， respectively. Conclusions Combined detection of CSF indicators including CSF total cell count， CSF white cell count， CSF： pro， along with routine blood markers such as neutrophil count and neutrophil percentage， holds significant clinical utility for differentiating between MCG and PCNSL.