| 米 芳,李小波,田晓甲.脑膜癌病的临床及脑脊液细胞学特征[J].肿瘤学杂志,2016,22(2):134-138. |
| 脑膜癌病的临床及脑脊液细胞学特征 |
| Clinical and Cerebrospinal Fluid Cytology Features of Meningeal Carcinomatosis |
| 投稿时间：2015-10-08 |
| DOI：10.11735/j.issn.1671-170X.2016.02.B012 |
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| 中文关键词: 脑膜癌病 脑脊液细胞学 MRI增强扫描 |
| 英文关键词:meningeal carcinomatosis cerebrospinal fluid cytology MRI enhancement scanning |
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| 中文摘要: |
| 摘 要：［目的］ 探讨脑膜癌病的临床特点及脑脊液细胞学对脑膜癌病的诊断意义。［方法］ 对68例确诊为脑膜癌病患者的临床及脑脊液细胞学资料进行回顾性分析。［结果］ 68例脑膜癌病患者首发症状以头痛（72%）、呕吐（54%）等颅内高压症为主，可伴脑神经和脊神经损害及脑膜刺激征。33例行头颅MRI增强检查可见18例出现不同程度的脑膜强化。CSF压力升高49例（72%)，白细胞数增多45例（66%），蛋白升高42例（62%），糖降低31例（45%），氯降低10例（15%）。所有患者脑脊液细胞学检查均发现肿瘤细胞，首次腰穿阳性率为44%。54例经临床及病理学找到原发肿瘤，14例来源未明。［结论］ 脑膜癌病临床表现缺乏特异性，早期以颅内高压症为主；头颅MRI增强扫描对脑膜癌病诊断有一定指导意义，但脑脊液细胞学检查仍是脑膜癌病确诊的主要依据，多次脑脊液细胞学检查可提高诊断阳性率；早期诊断和积极治疗是提高脑膜癌病患者生存率和改善预后的关键。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the clinical and cerebrospinal fluid cytology features in the diagnosis of meningeal carcinomatosis (MC). ［Methods］ The clinical data and cerebrospinal fluid cytology data of 68 cases diagnosed as MC were retrospectively reviewed. ［Results］ In 68 patients of MC，the starting symptoms showed chiefly headache (72%)，vomiting (54%)，also can be accompained by cranial nerve and spinal nerve lesions，and meningeal irritation signs. After cranial MRI enhancement scanning of 33 patients，18 cases had different degrees of meningeal reinforcement.CSF pressure increased in 49 cases(72%)，CSF white blood cells increased in 45 cases(66%)，CSF protein increased in 42 cases(62%)，sugar decreased in 31 cases(45%)，and chlorine decreased in 10 cases(15%). All the 68 cases found malignant cells in cytological examination of CSF，and the positive rate of lumbar puncture was 44% for the first time.Primary tumor origins of 54 patients were found through the clinical findings and pathological examination，and 14 cases were unknown source. ［Conclusions］ There is no specific clinical manifestations with MC，the main findings are intracranial hypertention in early stage.Cranial MRI enhanced scan may offer some valuable guidances for the diagnosis of MC，but CSF cytology is the main method to diagnose MC，and repeated detection of CSF cytology can enhance diagnosis rate. Early diagnosis and aggressive treatment are the key to improve survival rate and the prognosis of MC. |
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