摘要
目的探讨原发性中枢神经系统淋巴瘤(PCNSL)的临床特点及治疗方法。方法回顾性分析我院2000年～2009年收治的21例原发性中枢神经系统淋巴瘤患者的临床资料。结果本组21例患者以中年为主,临床表现和影像学缺乏特异性,病灶主要分布于幕上,单发病灶常见,全部经手术切除,病理均为B细胞型,其中弥漫大B细胞型19例,非生发中心起源占84.2%,1例EB病毒基因阳性,单纯手术5例,术后全脑放疗6例,联合化放疗10例,联合治疗的生存期明显比单纯手术或术后单纯化疗者延长。结论PCNSL表现复杂,术前诊断困难,确诊依靠病理,弥漫大B细胞型为主要病理类型,EB病毒可能参与疾病的发病机制,最佳治疗方案是包括大剂量甲氨蝶呤的化疗、放疗的综合治疗。
Objective To explore the clinical character and treatment of primary central nervous system lymphoma（PCNSL）.Methods Clinical datas of twenty-one cases of primary central nervous system lymphoma in our hospital from 2000 to 2009 were reviewed retrospectively.Results The clinics and imagings of those twenty-one patients,most middle-aged,were lack of specificity,and most lesions were solitary and mainly occurred in supratentorial.All the lesions were moved by operation for pathological examination.Their pathology was all identified as B cell types.Pathology of nineteen patients was diffuse large B cell lymphoma（DLBL）.Among them,non-geminal center origin was accounted for 84.2% and EB virus genome was positive in one patient.Five patients only accepted operation and six accepted whole brain radiotherapy after operation.The last ten patients were given combined therapy including operation,chemotherapy and radiotherapy.The survival of patients who accepted combined therapy was significantly longer than that of those who accepted surgery alone or postoperative radiotherapy.Conclusion PCNSL showed variable clinical feature,so it was difficult to diagnose preoperatively.The diagnosis is mainly determined by pathological examination.The DLBL is the main pathology classification,and EB virus might be involved in the pathophysiological mechanisms.Up to date,the best therapy should be the combined therapy including operation,chemotherapy and radiotherapy.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2010年第4期352-354,共3页
Journal of Apoplexy and Nervous Diseases
