脑膜癌病20例临床分析

目的:探讨脑膜癌病的临床特点及脑脊液细胞学改变。方法:对1998年9月到2004年12月收治的20例 经脑脊液细胞学证实的脑膜癌病患者的临床资料进行回顾性分析。结果:首发症状多以头痛、呕吐为主,可伴脑神经和 脊神经损害及脑膜刺激征;脑脊液检查颅内压均不同程度增高,另外还可表现细胞数、蛋白升高,糖、氯化物下降;细胞学 检查均发现癌细胞,其中有四例经丫啶橙荧光染色结果阳性。结论:脑脊液细胞学检查发现癌细胞是诊断脑膜癌病的重 要依据。

Objective： To explore clinical features and cytological changes of CSF m meningeal carcinomatosis. Methods： There were 20 patients with meningeal carcinomatosis that were diagnosed by cytological examination of CSF during September 1998 to December 2004. Those clinic data were retrospectively analyzed. Results.. Headache, vomiting were most of the capital symptoms of these meningeal carcinomatosis;cranial and spinal nerve and signs of meningeal irritation might be associated. There were abnormal levels of intracramal pressure in different extent（200mmH2O-950 mmH2O） ;increased cell count and protein level and decreased chloride and glucose levels were found in CSF examination. Cancer cells were found in the cytological examination of CSF;and there were 4 cases that showed positive staining for acridine orange fluorescent staining. Conclusions： Finding cancer cells in the cytological examination of CSF is the most important evidence for the diagnosis of meningeal carcinomatosis.