原发性中枢神经系统淋巴瘤的临床特点及生存分析

The clinical features and survival analysis of primary central nervous system lymphoma

目的:探讨原发性中枢神经系统淋巴瘤(PCNSL)的临床特点,加深对PCNSL临床特点的认识。方法:回顾性分析71例PCNSL患者的临床资料,并对54例可随访患者进行生存分析。结果:71例PCNSL患者构成比中,男性为多,男女比例1.73∶1;中老年为多,平均发病年龄52岁;起病至就诊时间多在3个月内;症状和体征多表现为颅内压力增高和局灶性定位体征;肿瘤以单发病灶多见(66.2%),大脑半球为最多发部位;肿瘤细胞来源均为B细胞性;可随访的54例患者,其中位生存期为17个月。结论:PCNSL的发生呈增加趋势;临床与影像学缺乏足够特异性因而早期诊断困难,确诊需依赖病理;治疗方面虽有一定进展,但是患者的生存期依然不长,长期缓解率和无病生存率依然不能令人满意。

Objective： To investigate the clinical features of primary central nervous system lymphoma （PC- NSL） and make a further understanding of PCNSL. Method： We presented a retrospective analysis of 71 patients with PCNSL. Data included clinical manifestations, image characteristics, tumor characteristics and survival time. Result： PCNSL predominantly occurred in the old patients with average age of 52 years. The man and woman ratio of 71 patients is 1.73 ： 1. More than 80% patients had symptoms for less than 3 months prior to seeking the medical attention. The symptoms or signs of elevated intracranial pressure and neurologic dysfunctions were the most common initial manifestations. Most tumors presented single mass. All of these 71 PCNSLs were B-cell lymphoma. In these 71 PCNSL patients, 54 patients were followed up. Kaplan-Meier test showed the median overall survival time was 17 months. Conclusion：PCNSL has rapidly increased in incidence over the past several decades. Usually, PCNSL has not characteristic clinical manifestations or findings of imaging scaning, which makes the early clinic diagnosis difficult. The pathological examination is the reliable method to confirm this disorder. The use of chemotherapy and radiotherapy has significantly improved the treatment of PCNSL. But the remission rate and overall survival time isn＇t satisfactory. More effective methods of diagnosis and treatment should be developed.