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[脑膜癌病患者脑脊液生化肿瘤标志物的检测]

[Measurements of CSF biochemical tumor markers in patients with meningeal carcinomatosis].

作者信息

Nakagawa H, Kubo S, Murasawa A, Nakajima S, Nakajima Y, Izumoto S, Hayakawa T

机构信息

Department of Neurosurgery, Center for Adult Diseases, Osaka.

出版信息

No Shinkei Geka. 1991 Dec;19(12):1135-41.

PMID:1766538
Abstract

CSF beta--glucuronidase, polyamines and carcinoembryonic antigen (CEA) were analyzed in 16 patients with meningeal carcinomatosis from solid tumors in systemic organs, 27 with benign brain lesions, 11 with primary brain tumors, 14 with metastatic brain tumors and 5 with leptomeningeal dissemination of other malignant diseases. beta--glucuronidase levels in all cases of meningeal carcinomatosis, meningeal gliomatosis and meningeal lymphoma were higher than 100 micrograms/dl/hr. On the other hand, levels in all cases of benign brain lesions were below 100 micrograms/dl/hr. Levels of beta--glucuronidase in the cases of metastatic brain tumors returned to normal levels after tumor resection. Levels of beta--glucuronidase and polyamines were not high in the cases with positive cytology in CSF after tumor resection. The polyamine level seemed to be dependent on the growth rate of the disease and was shown to below 0.05 nmol/ml in all cases after resection of the metastatic brain tumors. Cystic fluid of both benign and malignant tumor showed high levels of beta--glucuronidase and polyamines except for spermidine and spermine levels in a suprasellar cyst. Some cases of meningeal carcinomatosis with high levels of serum CEA did not always show high levels of CSF CEA. In the surgical cases with a metastatic brain tumor, the cases with leptomeningeal, especially dural attachment showed high levels of beta--glucuronidase and CEA preoperatively, but they returned to normal after surgery. In 2 cases of meningeal carcinomatosis treated by intrathecal chemotherapy with MTX and Ara-C, CSF beta--glucuronidase and CEA showed clinical condition better than the cell count in CSF decreased rapidly following chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对16例系统性器官实体瘤所致脑膜癌病患者、27例良性脑病变患者、11例原发性脑肿瘤患者、14例转移性脑肿瘤患者以及5例其他恶性疾病软脑膜播散患者的脑脊液β-葡萄糖醛酸酶、多胺和癌胚抗原(CEA)进行了分析。所有脑膜癌病、脑膜胶质瘤病和脑膜淋巴瘤病例中的β-葡萄糖醛酸酶水平均高于100微克/分升/小时。另一方面,所有良性脑病变病例中的水平均低于100微克/分升/小时。转移性脑肿瘤病例在肿瘤切除后β-葡萄糖醛酸酶水平恢复正常。肿瘤切除后脑脊液细胞学检查阳性的病例中β-葡萄糖醛酸酶和多胺水平不高。多胺水平似乎取决于疾病的生长速度,转移性脑肿瘤切除后的所有病例中其水平均显示低于0.05纳摩尔/毫升。除鞍上囊肿中的亚精胺和精胺水平外,良性和恶性肿瘤的囊液均显示出高水平的β-葡萄糖醛酸酶和多胺。一些血清CEA水平高的脑膜癌病病例脑脊液CEA水平并不总是高。在有转移性脑肿瘤的手术病例中,有软脑膜受累尤其是硬脑膜附着的病例术前β-葡萄糖醛酸酶和CEA水平高,但术后恢复正常。在2例接受甲氨蝶呤和阿糖胞苷鞘内化疗的脑膜癌病病例中,脑脊液β-葡萄糖醛酸酶和CEA显示临床状况改善,优于化疗后脑脊液细胞计数迅速下降的情况。(摘要截选至250词)

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