原发性中枢神经系统淋巴瘤43例临床分析

Primary central nervous system lymphoma:report of 43 cases

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)的临床特征、治疗及预后。方法对43例 PCNSL 患者的临床资料进行回顾性分析。结果 PCNSL 患者临床表现无特异性,颅内压增高、神经功能缺失为常见症状。本组患者中位生存时间18.0个月(95% CI 14.2～21.8个月)。Cox 回归分析显示室管膜、脑膜受累与否是影响预后的因素(P=0.002)。结论 PCNSL 预后差且术前诊断困难,其最佳治疗方案仍在探索之中。

Objective To explore the clinical characteristics, therapy and prognosis of primary central nervous system lymphoma （ PCNSL）. Methods Forty-three PCNSL patients were retrospectively analyzed. Results The most frequent PCNSL clinical presentations were an increased intracranial pressure, focal neurologic deficits. The median survival time of patients was 18.0 months （ 14. 2-21.8 months, 95% CI）. Cox regression model analysis revealed that ependymal and leptomeningeal involvement was the only independent factor for overall survival （ P = 0. 002 ）. Conclusions PCNSL is a aggressive disease with a poor prognosis and difficult to diagnose before operation. The optimal treatment modality for newly diagnosed PCNSL is still under investigation.