CAJ | 학술논문

目的：研究原发性中枢神经系统淋巴瘤（PCNSL）的诊断及合理治疗方案。方法回顾性分析经术后病理证实的43例PCNSL患者的临床资料。结果 PCNSL以中老年人多见，临床表现复杂多样，病程短，病情进展快。MRI增强扫描病灶多呈均匀明显强化，可单发或多发。43例中单纯手术7例，术后全脑放疗15例，术后化疗11例，联合放化疗10例，联合治疗的患者中位生存期明显延长。结论 PCNSL临床表现无特征性，影像学特征不典型，病理诊断仍是确诊的金标准。PCNSL单纯手术治疗效果较差，采用包括手术和放化疗在内的综合治疗可提高疗效。
목적：연구원발성중추신경계통림파류（PCNSL）적진단급합리치료방안。방법회고성분석경술후병리증실적43례PCNSL환자적림상자료。결과 PCNSL이중노년인다견，림상표현복잡다양，병정단，병정진전쾌。MRI증강소묘병조다정균균명현강화，가단발혹다발。43례중단순수술7례，술후전뇌방료15례，술후화료11례，연합방화료10례，연합치료적환자중위생존기명현연장。결론 PCNSL림상표현무특정성，영상학특정불전형，병리진단잉시학진적금표준。PCNSL단순수술치료효과교차，채용포괄수술화방화료재내적종합치료가제고료효。
Objective To explore the diagnosis and treatment of primary central nervous system lymphoma (PCNSL). Methods The clinical data of 43 cases with primary central nervous system lymphoma were analyzed retrospectively. Results These patients were middle or old age, with variable clinical features, short course of disease and a rapid process. Enhanced scanning showed the lesion was contrasted evenly and obviously with solitary or multiple. Among the 43 cases, 7 patients only underwent surgery and 15 accepted whole brain radiotherapy after operation. 11 patients accepted chemotherapy after operation. The last 10 patients were given combined therapy including resection, radiotherapy and chemotherapy. The median survival of patients who accepted combined therapy was significantly longer than who accepted surgery alone or postoperative radiotherapy. Conclusion The effect of treatment was poor with surgery alone, and it is critical to use combined therapy including operation, radiotherapy and chemotherapy to elevate therapeutic effect. It was contributed to misdiagnosis since PCNSL showed no characteristic clinical features and no typical radiographic manifestations.