中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2001年
5期
325-328
,共4页
淋巴瘤%中枢神经系统%预后%无病生存
淋巴瘤%中樞神經繫統%預後%無病生存
림파류%중추신경계통%예후%무병생존
目的探讨原发中枢神经系统淋巴瘤（PCNSL）的临床特点以及预后因素的分析，为临床上对该疾病的诊断和治疗提供依据。方法总结我院1993年1月至2000年5月诊治的22例PCNSL患者的临床资料，做一回顾性分析，并对各可能预后因素做单因素、多因素回归分析。结果 22例PCNSL中男、女各 11例，年龄17～81岁，平均年龄49.5岁。22例中有效随访20例，在随访终点存活9例，死亡11例，存活期1～81个月，中位生存时间14.5个月。并发现是否做过鞘内注射（P=0.005）及累及部位是局限或弥漫(P=0.031)是与生存长短相关的两大预后因素。结论 PCNSL发病率仅千万分之一，近年来国外文献报道其发病率有增长势头。手术治疗是PCNSL的主要治疗方法。术后治疗也应当积极，有条件尽量实施鞘内注射,全身化疗是否能进一步提高生存期，有待于增加病例数后进一步统计分析。
目的探討原髮中樞神經繫統淋巴瘤（PCNSL）的臨床特點以及預後因素的分析，為臨床上對該疾病的診斷和治療提供依據。方法總結我院1993年1月至2000年5月診治的22例PCNSL患者的臨床資料，做一迴顧性分析，併對各可能預後因素做單因素、多因素迴歸分析。結果 22例PCNSL中男、女各 11例，年齡17～81歲，平均年齡49.5歲。22例中有效隨訪20例，在隨訪終點存活9例，死亡11例，存活期1～81箇月，中位生存時間14.5箇月。併髮現是否做過鞘內註射（P=0.005）及纍及部位是跼限或瀰漫(P=0.031)是與生存長短相關的兩大預後因素。結論 PCNSL髮病率僅韆萬分之一，近年來國外文獻報道其髮病率有增長勢頭。手術治療是PCNSL的主要治療方法。術後治療也應噹積極，有條件儘量實施鞘內註射,全身化療是否能進一步提高生存期，有待于增加病例數後進一步統計分析。
목적탐토원발중추신경계통림파류（PCNSL）적림상특점이급예후인소적분석，위림상상대해질병적진단화치료제공의거。방법총결아원1993년1월지2000년5월진치적22례PCNSL환자적림상자료，주일회고성분석，병대각가능예후인소주단인소、다인소회귀분석。결과 22례PCNSL중남、녀각 11례，년령17～81세，평균년령49.5세。22례중유효수방20례，재수방종점존활9례，사망11례，존활기1～81개월，중위생존시간14.5개월。병발현시부주과초내주사（P=0.005）급루급부위시국한혹미만(P=0.031)시여생존장단상관적량대예후인소。결론 PCNSL발병솔부천만분지일，근년래국외문헌보도기발병솔유증장세두。수술치료시PCNSL적주요치료방법。술후치료야응당적겁，유조건진량실시초내주사,전신화료시부능진일보제고생존기，유대우증가병례수후진일보통계분석。
Objective The authors present a retrospective analysis of 22 patients with primary central nervous system lymphoma(PCNSL) in order to provide a reasonable basis for the diagnosis and treatment of the disease. Methods This report involves a clinicopathological study of 22 patients with histologically proven PCNSL,all diagnosed between January 1993 and May 2000. Univariate and multivariate regression analysis are used to determine prognostic factors significantly associated with an unfavorable or favorable impact on survival. Results The cohort included 11 men and 11 women whose median age at diagnosis was 49.5 years. At the end point of follow-up, 11 died. The median survival time for the patients in study was 14.5 months. With univariate and multivariate regression analysis, prognostic factors significantly associated with survival included intrathecal injection(P=0.005) and local/diffuse neurological deficit(P=0.031). Conclusion There continues to be a significantly increasing incidence of PCNSL. This survey throws light on the clinical and prognostic features of this uncommon disease. Through univariate and multivariate regression analysis the authors highly recommend a theraputic regime including surgery, intrathecal injection and chemotherapy, especially those drugs capable of passing blood-brain barrier, for example high dose MTX.
