肺癌转移致脑膜癌病12例临床分析

Clinical analysis of meningeal carcinomatosis caused by metastasis of lung cancer

目的分析12例肺癌致脑膜癌病患者的临床特征。方法对12例经脑脊液细胞学证实的肺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,鞘内注射加全身化疗是有效的治疗手段。

Objective To analyze the clinical characteristics in 12 patients with meningeal carcinoimatosis caused by metastasis of lung cancer. Methods The clinical data of 12 patients with meningeal carcinomatosis caused by metastasis of lung cancer,diagnosed by CSF cytological detection, were analyzed retrospectively. Results Most of the incipient symptoms were headache and vomiting. Rsults 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 response rate after treatment was 25 %. Conclusion The meningeal carcinomatosis should be highly suspected in patients with the symptoms such as headache and vomiting,signs of meningeal irritation,increased ICP, even presen- ting normal CT or MR imaging. The intrathecal and intravenous chemotherapy in an effective method for meningeal carcinomatosis.