颅内转移性肿瘤136例临床分析

CLINICAL ANALYSIS OF 136 PATIENTS WITH INTRACRANIAL METASTASES

目的为早期诊断和合理治疗颅内转移肿瘤提供临床依据方法对１３６例颅内转移性肿瘤原发灶和转移灶的关系、病理类型、临床和影像学表现、治疗方法和疗效进行回顾分析。结果（１）肺癌、消化系癌和乳腺癌最常发生颅内转移；（２）颅内转移癌最常见的为腺癌、鳞癌和未分化癌；（３）发现原发肿瘤到出现脑转移症状大多不到半年；（４）脑转移癌首发症状主要为头痛、偏瘫和精神障碍；（５）脑转移癌ＣＴ和ＭＲＩ增强扫描都表现强化效应，都存在瘤周水肿；（６）单发脑肿瘤手术加放疗有显著效果。结论（１）癌症患者一理出现神经系统症状时，应进行ＣＴ或ＭＲＩ检查明确颅内转移；（２）颅内转移癌应尽量争取手术和放谢治疗。

PURPOSE To elucidate clinical evidence for early diagnosis and treatment of intracranial metastasis. METHODS The clinical data of 136 cases of patients with intracranial metastases were reviewed. RESULTS ①Malignant tumors from the lung, the digestive system and the breast were the most common ones that metastasized into the cranium.② Adenocarcinoma, squamous cell carcinoma and undifferentiated carcinoma were the most common intracranil metastatic tumors.③ The uration from extracranial primary cancer to brain metastasis was often less than half a year.④ Most patients with brain metastases first presented headache, hemiplegia and psychiatrical disorder.⑤ Severe brain edema was always found around the tumor. The tumor always presented intensive effect in enhancing CT nd Mri scanning.⑥ Surgical resection followed by radiotherapy in patients with single brain metastatic tumor produced good effect. CONCLUSIONS ①Patients with extracranial cancer having neurological deficiency should be examined by CT and MRI to identify potential bain metastasis.②Patients with single brain metastatic tumor should receive surgical resection plus radiotherapy as early as possible.