脑膜癌病13例临床及脑脊液细胞学分析

Cerebrospinal Fluid Cytology Analysis On 13 Cases of Leptomeningeal Carcinomatosis

目的：探讨脑膜癌病（LC）患者的临床及脑脊液细胞学（CSFC）特点。方法：回顾性分析13例LC患者的临床资料及脑脊液细胞学。结果：LC呈亚急性起病,进行性加重,以头痛伴恶心、呕吐等颅高压征为主要临床表现,部分患者可伴有脑神经或脊神经受损的表现;CSF中白细胞数（10～50）×10^6/L11例,蛋白增高8例,葡萄糖减少4例;10例颅内压增高,最高达320mmH2O;CSFC检查13例CSF中发现10%～46%的肿瘤细胞;3例做免疫单抗组化染色CEA（癌胚抗原）、EMA（上皮膜抗原）、CK18（细胞角蛋白18）及PAS（糖元）染色均为阳性。结论：CSF中找到特异性肿瘤细胞对LC的诊断具有重要价值,CSF免疫单抗细胞化学染色有助于提高LC的诊断阳性率。

Objective：To discuss the characteristics of clinical and cerebrospinal fluid cytology on leptomeningeal carcinomatosis（LC）.Methods：To make a retrospective analysis of clinical data and cerebrospinal fluid cytology（CSFC） on 13 cases of leptomeningeal carcinomatosis.Results：The clinical manifestation of LC was subacute attack,progressive severe,accompanied headache,nausea,and vomiting.Part of the patients could appear cranial or spinal nerve damage.Cytological examination showed that leukocyte count was（10～50）×106 /L in 11 cases,protein concentration increased in 8 cases,glucose decreased in 4 cases,10 cases was intracranial hypertension and the highest value was 320 mmH2O.CSFC laboratory check showed that 13 cases was found 10%～46% tumor cells in CSF.3 cases were received the examination of immunohistochemistry CEA,EMA,CK18 and PAS,and the results showed positive.Conclusion： Finding specific tumor cells in CSF has important value in diagnosis of LC.Immunohistochemistry can help to promote the diagnostic positive rate.