Liu J, Jia H, Yang Y, Dai W, Su X, Zhao G
Department of Neurology, Xijing Hospital of the Fourth Military Medical University, Xi'an City, Shaanxi Province, China.
J Int Med Res. 2009 Nov-Dec;37(6):1913-20. doi: 10.1177/147323000903700629.
The clinical characteristics and cerebrospinal fluid (CSF) cytological features of 34 hospitalized patients with leptomeningeal carcinomatosis (LC) were studied. Most patients presented with signs of meningeal irritation (19 cases) and intra-cranial hypertension (23 cases). Computed tomography (CT) and/or magnetic resonance imaging (MRI) revealed brain parenchymal lesions, hydrocephalus and leptomeningeal enhancement (nine, six and eight cases, respectively). The CSF changes included high opening pressure (21 cases), increased white blood cell count (23 cases), elevated protein levels (25 cases) and low glucose levels (17 cases). Malignant cells were found in all CSF specimens and 32 cases had malignant cells in their initial CSF examinations. High serum levels of carcinoembryonic antigen (CEA) occurred in 11 patients. Signs of meningeal irritation and intra-cranial hypertension were common. It is concluded that serum CEA measurement along with CT and MRI scanning are helpful in the diagnosis of LC. Crucially, however, CSF cytology could be the most important technique for the diagnosis of LC.
对34例住院的柔脑膜癌病（LC）患者的临床特征和脑脊液（CSF）细胞学特征进行了研究。大多数患者表现为脑膜刺激征（19例）和颅内高压（23例）。计算机断层扫描（CT）和/或磁共振成像（MRI）显示脑实质病变、脑积水和柔脑膜强化（分别为9例、6例和8例）。脑脊液变化包括初压升高（21例）、白细胞计数增加（23例）、蛋白水平升高（25例）和葡萄糖水平降低（17例）。所有脑脊液标本中均发现恶性细胞，32例患者在初次脑脊液检查时发现恶性细胞。11例患者血清癌胚抗原（CEA）水平升高。脑膜刺激征和颅内高压很常见。结论是，血清CEA检测以及CT和MRI扫描有助于LC的诊断。然而，至关重要的是，脑脊液细胞学检查可能是诊断LC最重要的技术。
