Meningeal carcinomatosis (MC) is a disease that malignant tumor cells cultivate in the cerebrospinal fluid or meninges. With the development of therapy methods and new techniques, survival time of patients with tumor ...Meningeal carcinomatosis (MC) is a disease that malignant tumor cells cultivate in the cerebrospinal fluid or meninges. With the development of therapy methods and new techniques, survival time of patients with tumor is prolonged, and the incidence of MC is increasing. Diagnosis is based on the evaluation of clinical manifestations, cerebrospinal fluid and neuroimaging findings. Furthermore, in recent years, the diagnostic value of the tumor-derived cell-free DNA in the cerebrospinal fluid (CSF) is promising and may improve the diagnostic yield of CSF analysis. Traditional treatments of MC include surgery, radiation therapy, systemic therapy, and intrathecal therapy. Recently, molecular targeted therapy and immunotherapy have received more and more attention. The authors review the epidemiology, pathogenesis, clinical manifestation, diagnosis and treatment of MC in solid cancer, and discuss the diagnosis and treatment options currently available as well as those under investigation.展开更多
Cryptococcal meningitis(CM)is a central nervous system infectious disease caused by Cryptococcus.It is the most common fungal infection in the central nervous system,accounting for about 48%of fungal infection.The dis...Cryptococcal meningitis(CM)is a central nervous system infectious disease caused by Cryptococcus.It is the most common fungal infection in the central nervous system,accounting for about 48%of fungal infection.The disease occurs mainly in acquired immunodeficiency syndrome(AIDS)patients and concentrates in the immunocompromised people without AIDS.There are nearly one million new cases of CM each year,and about 70%of them died.In China,CM occurs mainly in people without AIDS and there is an increasing trend in recent years.Early diagnosis and treatment is the key to reducing morbidity and mortality associated with CM.The diagnosis mainly depends on laboratory examination such as morphological examination,fungal culture and antigen detection.History,clinical manifestation and imaging examination are the important parts of auxiliary examination.The initial combined antifungal treatment is emphasized,and the principle of fractional treatment including induction,consolidation and maintenance therapy should be followed.The high intracranial pressure must be reduced actively at the same time.In addition,it is proved that the novel immunotherapy combined with antifungal agents can improve the curative effect and limit the chance of antimicrobial resistance.Large-scale clinical trials are needed for further study.展开更多
文摘Meningeal carcinomatosis (MC) is a disease that malignant tumor cells cultivate in the cerebrospinal fluid or meninges. With the development of therapy methods and new techniques, survival time of patients with tumor is prolonged, and the incidence of MC is increasing. Diagnosis is based on the evaluation of clinical manifestations, cerebrospinal fluid and neuroimaging findings. Furthermore, in recent years, the diagnostic value of the tumor-derived cell-free DNA in the cerebrospinal fluid (CSF) is promising and may improve the diagnostic yield of CSF analysis. Traditional treatments of MC include surgery, radiation therapy, systemic therapy, and intrathecal therapy. Recently, molecular targeted therapy and immunotherapy have received more and more attention. The authors review the epidemiology, pathogenesis, clinical manifestation, diagnosis and treatment of MC in solid cancer, and discuss the diagnosis and treatment options currently available as well as those under investigation.
文摘Cryptococcal meningitis(CM)is a central nervous system infectious disease caused by Cryptococcus.It is the most common fungal infection in the central nervous system,accounting for about 48%of fungal infection.The disease occurs mainly in acquired immunodeficiency syndrome(AIDS)patients and concentrates in the immunocompromised people without AIDS.There are nearly one million new cases of CM each year,and about 70%of them died.In China,CM occurs mainly in people without AIDS and there is an increasing trend in recent years.Early diagnosis and treatment is the key to reducing morbidity and mortality associated with CM.The diagnosis mainly depends on laboratory examination such as morphological examination,fungal culture and antigen detection.History,clinical manifestation and imaging examination are the important parts of auxiliary examination.The initial combined antifungal treatment is emphasized,and the principle of fractional treatment including induction,consolidation and maintenance therapy should be followed.The high intracranial pressure must be reduced actively at the same time.In addition,it is proved that the novel immunotherapy combined with antifungal agents can improve the curative effect and limit the chance of antimicrobial resistance.Large-scale clinical trials are needed for further study.
