胃癌转移致脑膜癌病临床分析

Clinical Analysis of Meningeal Carcinomatosis Caused by Metastasis of Gastric Cancer

目的:分析16例胃癌致脑膜癌病的临床特征。方法:对16例经脑脊液细胞学证实的胃癌致脑膜癌病患者的临床资料进行分析。结果:首发症状多为头痛、呕吐,头颅CT或MRI检查多无异常发现,脑脊液检查颅内压均有不同程度增高,脑脊液生化检查蛋白升高者多见,细胞学检查均见癌细胞,形态与原发肿瘤相似,经治疗后31.25%的患者获得缓解。结论:对以头痛、呕吐发病,伴颅内压增高及脑膜刺激征,且CT及MRI检查无明显异常者,应高度警惕脑膜癌病的可能,鞘内加全身化疗是有效的治疗手段。

Objective： To analyze the clinical characteristics in 16 patients with meningeal carcinoimatosis caused by metastasis of gastric cancer. Methods： The clinical data of 16 patients with meningeal carcinomatosis caused by metastasis of gastric cancer, diagnosed by CSF cytological detection, were analyzed retrospectively. Results： Most of the incipient symptoms were headache and vomiting. Results for most of the CT or MR imaging were normal. There were abnormal levels of intracranial pressure in different extent, increased protein level was found in CSF examination. Cancer cells were found and their morphological appearances were similar with that in primary tumor. The overall re- sponse rate after treatment was 31.25%. Conclusions： The meningeal carcinomatosis should be highly suspected in patients with the symptoms such as headache and vomiting, signs of meningeal irritation, increased ICP, even presenting normal CT or MR imaging. The intrathecal and intravenous chemotherapy is an effective method for meningeal carcinomatosis.