[中枢神经系统淋巴瘤及其意义]

[Central nervous system lymphoma and its significance].

作者信息

Zheng Wen, Lin Ning-jing, Xie Yan, Wang Xiao-pei, Tu Mei-feng, Liu Wei-ping, Song Yu-qin, Ping Ling-yan, Ying Zhi-tao, Deng Li-juan, Zhang Chen, Zhu Jun

机构信息

Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Jun 14;91(22):1550-4.

PMID:21914369

Abstract

OBJECTIVE

To explore the clinical features, diagnosis, treatment and prognosis of central nervous system lymphoma (CNSL).

METHODS

Retrospective analysis was conducted for 31 CNSL cases from January 2007 to December 2009 in our hospital. Their clinical data were analyzed by statistical software package SPSS 16.0.

RESULTS

Accounting for around 4.7% of all lymphomas at our institution, the present cohort had 21 males and 10 females with a median age of 38 years old. The major clinical manifestations were focal neurological deficits associated with the site of disease or increased intracranial pressure. Most patients were treated with chemotherapy-based regimens. The overall response rate was 67.7% (21/31) with 32.3% (10/31) complete remission rate (CR) and 35.5% (11/31) partial remission rate (PR). Involvement outside CNS or bone marrow, high international prognostic index (IPI) and B symptoms had significant effects on the therapeutic efficacy (P < 0.05). The overall survival rates were 80.7%, 74.2%, 64.5% and 58.1% at 3, 6, 12, 24 months respectively. The median survival time was 22.5 months. Univariate analysis showed that the clinical efficacy had significant effects on the overall survival of patients (OR = 0.030, 95%CI: 0.003 - 0.270, P = 0.000).

CONCLUSION

The prognosis of CNSL remains poor. New diagnostic tools and treatment modality need to be explored.

摘要

目的

探讨中枢神经系统淋巴瘤（CNSL）的临床特征、诊断、治疗及预后。

方法

对我院2007年1月至2009年12月收治的31例CNSL患者进行回顾性分析。采用统计软件包SPSS 16.0对其临床资料进行分析。

结果

该队列占我院所有淋巴瘤的4.7%左右，其中男性21例，女性10例，中位年龄38岁。主要临床表现为与病变部位相关的局灶性神经功能缺损或颅内压升高。大多数患者接受了以化疗为主的方案治疗。总缓解率为67.7%（21/31），完全缓解率（CR）为32.3%（10/31），部分缓解率（PR）为35.5%（11/31）。CNS外或骨髓受累、高国际预后指数（IPI）及B症状对治疗效果有显著影响（P<0.05）。3、6、12、24个月的总生存率分别为80.7%、74.2%、64.5%和58.1%。中位生存时间为22.5个月。单因素分析显示，临床疗效对患者的总生存有显著影响（OR = 0.030，95%CI：0.003 - 0.270，P = 0.000）。