脑膜癌病临床诊断流程化策略分析

A clinical study on diagnostic process strategy of meningeal carcinomatosis

目的 探讨脑膜癌病（MC）临床诊断的可行性流程化策略.方法 对5例病理学确诊MC患者的临床资料进行综合分析,并结合文献复习进行总结.结果 5例患者急性或亚急性起病,有或无肿瘤病史;临床有脑/脊膜神经轴线受损的症状体征,包括不同程度颅高压症状、脑脊膜包裹的颅神经和脊神经受损症状体征及脑膜刺激征;脑脊液压力高,生化有一定改变,脑脊液中找到腺癌细胞;5例均有肿瘤标志物CEA的升高;1例患者的磁共振检查发现脑膜可见多发条状、结节状强化灶.结论 脑脊膜轴线受损症状、体征是MC定位诊断依据,规范化脑脊液查找到肿瘤细胞是病理确诊的重要手段.

Objective To explore the feasibility processize strategy on clinical diagnosis of patients with meningeal carcinomatosis. Methods The clinical data of five patients with pathologically confirmed meningeal carcinomatosis in were rerospectively analyzed. And the development of meningeal carcinomatosis were reviewed. Results Five patients developed acute or subacute onset with or without tumor history. Clinical symptoms and signs were examined on meningeal nerve axis lesions, including the different degree of intracranial hypertension symptoms, signs of cranial nerve and spinal nerve damaged, and meningeal irritation signs. High pressure, biochemical data changes, and adenocarcinoma cells were found in CSF. The tumor marker CEA was high in all five cases. The multiple strip and nodositas intensified foci located in the meninges were displayed in MRI of one patient. Conclusions Symptoms and signs of meningeal nerve axis lesions are the basis of MC top-ical diagnosis. Finding tumor cells in the CSF with standardized test methods is an important way for pathological diagnosis of MC.