中枢神经系统淋巴瘤预后预测及复发监测方法

Methods for predicting prognosis and monitoring recurrence in patients with central nervous system lymphoma

原发性中枢神经系统淋巴瘤(PCNSL)是高度侵袭性恶性肿瘤, 多数化疗药物难以穿过血脑屏障, 因此PCNSL治疗难度大, 复发率高, 预后差。早期识别复发并开始挽救治疗是改善PCNSL患者预后的关键。脑组织活组织检查虽是识别复发的金标准, 但操作失败及出现并发症的风险较大。无创影像学技术有助于PCNSL复发的早期识别, 为指导复发患者及时调整治疗方案提供重要依据, 但目前用于监测PCNSL复发病灶的影像学手段仍无统一的评判标准。随着对PCNSL病理生理机制研究的深入, 生物标志物检测成为识别复发的新手段, 但仍需更多临床证据支持。

Primary central nervous system lymphoma(PCNSL)is a highly aggressive malignant lymphoma.As most chemotherapy drugs have difficulty in crossing the blood-brain barrier,PCNSL shows a difficulty in clinical treatment,a high recurrence rate and a poor prognosis.Early identification of relapsed patients and prompt initiation of salvage therapy play a critical role in the improvement of patients'prognosis.Brain biopsy is the gold standard to identify recurrence,while the risk of operation failure and complications is still high.Non-invasive imaging techniques are beneficial for early identification of recurrence in PCNSL and can provide an important basis for guiding relapsed patients to adjust treatment plans in time.However,there is no unified evaluation standard for imaging methods of monitoring the relapsed lesions of PCNSL.With the further research of the pathophysiological mechanism of PCNSL,biomarker detection has become a new method to identify recurrence and more clinical evidence is still needed in the future.