摘要
目的探讨原发性颅内淋巴瘤（PCNSL）的外科治疗价值。方法回顾性分析2001年至2005年收治的16例PCNSL的临床特征、影像资料及治疗方法与结果。结果16例患者均经手术病理确诊，术中全切9例，次全切除5例，大部分切除2例。11例手术患者于术后2周辅以放射治疗，6例病人予以化疗，采用CHOP方案。术后除1例因反复术野出血早期死亡外，其他病例临床症状均得到不同程度的缓解。12例随访3-60个月，目前仍有3例存活，采用手术＋放化疗的综合治疗措施病例生存时间比单一治疗方法生存时间长。结论PCNSL临床症状及影像学无特征性，诊断困难，误诊率高。手术病理检查是重要的诊断方法，手术＋放化疗的综合治疗措施是延长病人生存时间的有效方法，手术仍为PCNSL的重要治疗手段。
Objective To explore the treatment motalities of primary central nervous system lymphoma （PCNSL） and the therapeutic value of surgery. Methods The data of 16 cases with PCNSL treated in our department from 2001 to 2005 were analyzed retrospectively including clinical characteristics, imaging features and treatment methods. Results The diagnosis was confirmed by the histopathology exam in all cases. All patients received surgical treatment. Tumor was removed totally in 9 cases, resected subtotally in 5 cases, and mostly in 2 cases. Radiotherapies were performed in 11 cases 2 weeks after operation, and chemotherapies of CHOP regime were administered in 6 cases. The clinical presentation was improved postoperatively in all patients but 1 who died 15 days after operation because of repeated severe intracranial hemorrhage. 12 patients had been followed up during 3-60 months, among of them, 3 patients are still alive. The survive time was more in patients obtained the multidisciplinary treatments combining surgery and radio-chemotherapy than the patients received only single treatment. Conclusion PCNSL usually presents with the non-characteristic changes in clinical manifestation or imaging scanning, resulting in difficult establishment of the diagnosis and sometimes misdiagnosis. The pathological exam including immunohistochemical test is very important in diagnosis. The acceptable survive time of patient with PCNSL could be increased by the multidisciplinary including surgery, radiotherapy and chemotherapy, among which surgery is still the important treatment to PCNSL.
出处
《中华神经外科杂志》
CSCD
北大核心
2008年第2期123-126,共4页
Chinese Journal of Neurosurgery
关键词
淋巴瘤
中枢神经系统肿瘤
外科手术
Lymphom
Central nervous system neoplasm
Surgical procedures, operative
