原发性中枢神经系统淋巴瘤的诊疗、预后附19例病例分析

发布时间：2019-03-30 09:02

【摘要】：目的：通过收集本科19例确诊为淋巴瘤病人的资料,提高对原发性中枢神经系统淋巴瘤的诊断准确率,改善治疗方法,延长患者预后生存周期。方法：回顾性分析自2011年9月至2013年6月在我科行手术治疗,术后病理确诊为原发性中枢神经系统淋巴瘤的病人,通过对原发性中枢神经系统淋巴瘤的影像学特点、脑脊液检测、脊髓学检测及病理学特点进行分析,以求提高原发性中枢神经系统淋巴瘤的诊断。通过19例患者除4例失访患者外,剩余15例随访患者在经过3-27个月的随访期后,对患者的生存率、生存者中有生活自理能力患者人数、肿瘤复发率、肿瘤复发后死亡率、肿瘤的病理分型等数据进行统计分析,分析出影响原发性中枢神经系统淋巴瘤的治疗及预后因素。结果：19例患者中4例患者失访,剩余15例随访病人,6例患者截止随访期存活,9例患者死亡。6例患者中仅1例有生活自理能力。同时,15例患者中,7例患者肿瘤复发,7例肿瘤复发患者中5例患者死亡。19例病人中17例病人的病理类型为弥漫大B细胞淋巴瘤。结论：原发性中枢神经系统淋巴瘤术前明确诊断困难,治疗棘手,术后并发症多,术后死亡率高,术后放疗联合化疗可提高患者的生存周期及改善生活质量。
[Abstract]:Aim: to improve the accuracy of diagnosis of primary central nervous system lymphoma (CNS) by collecting the data of 19 cases diagnosed as lymphoma, and to improve the treatment method and prolong the life cycle of prognosis. Methods: from September 2011 to June 2013, we retrospectively analyzed the imaging features of primary central nervous system lymphoma in patients with primary central nervous system lymphoma, who underwent surgical treatment from September 2011 to June 2013, and who were pathologically diagnosed as primary central nervous system lymphoma after operation. Cerebrospinal fluid examination, spinal cord examination and pathological characteristics were analyzed in order to improve the diagnosis of primary central nervous system lymphoma. After a follow-up period of 3 months and 27 months, the survival rate of the patients, the number of patients with the ability to take care of themselves, the recurrence rate of the tumor, and the mortality rate after the recurrence of the tumor were studied in 19 patients, except 4 missing patients, and the remaining 15 patients were followed up for 3 months and 27 months after the follow-up period. The factors affecting the treatment and prognosis of primary central nervous system lymphoma (PNS) were analyzed by statistical analysis of the pathological types of tumors. Results: of the 19 patients, 4 patients lost follow-up, the remaining 15 patients were followed-up, 6 patients survived until the follow-up period, 9 patients died, and only one of the 6 patients had the ability to take care of themselves. At the same time, of the 15 patients, 7 had tumor recurrence, 5 had died of tumor recurrence, and 17 of 19 patients had diffuse large B-cell lymphoma. Conclusion: preoperative diagnosis of primary central nervous system lymphomas is difficult and difficult to treat. There are many complications and high mortality after operation. Postoperative radiotherapy combined with chemotherapy can improve the life cycle and quality of life of the patients.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4

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