Objective:To explore the cytokine expression levels in cerebrospinal fluid(CSF)of patients with neurosyphilis(NS)and evaluate their diagnostic value for NS.Methods:A total of 194 syphilis patients were included for this study,inclu-ding 41 patients with NS and 153 patients with non-neurosyphilis(NNS).All participants underwent lumbar puncture.Gener-al information(age,sex)and CSF laboratory test results,including white blood cell count,protein,chloride,Pandy's test,cyto-kines[tumor necrosis factor-alpha(TNF-α),interferon-gamma(IFN-γ),interleukin-2(IL-2),IL-4,IL-6,IL-10,IL-17A]were collected and compared between the two groups.Spearman correlation analysis was performed to examine the correlation be-tween CSF cytokines and white blood cell count and protein levels.Multivariate Logistic regression analysis was used to identi-fy independent predictors,and receiver operating characteristic(ROC)curves were plotted to assess diagnostic performance.Results:NS patients showed higher levels of age,positive Pandy's test,white blood cell count,protein concentration,TNF-α,IFN-γ,IL-2,IL-4,IL-6,IL-10,and IL-17A compared to NNS patients(P<0.05).TNF-α,IFN-γ,IL-2,IL-4,IL-6,IL-10,and IL-17A were positively correlated with both CSF white blood cell count and protein concentration(P<0.05).Multivariate Lo-gistic regression revealed that IL-6,IL-10,and IL-17A(OR=1.112,1.114,1.235)were independent predictors of NS(P<0.05).The areas under the curve(AUC)for IL-6,IL-10,and IL-17A were 0.903,0.893,and 0.844,respectively,and the com-bined AUC for all three indicators was 0.936.Conclusion:The expression levels of multiple cytokines in the CSF of NS pa-tients are elevated and positively correlated with CSF white blood cell count and protein concentration.IL-6,IL-10,and IL-17A can serve as auxiliary diagnostic indicators for NS.