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脑肿瘤的流行病学与诊断

Epidemiology and diagnosis of brain tumors.

作者信息

Butowski Nicholas A

出版信息

Continuum (Minneap Minn). 2015 Apr;21(2 Neuro-oncology):301-13. doi: 10.1212/01.CON.0000464171.50638.fa.

Abstract

PURPOSE OF REVIEW

Brain tumors consist of a collection of neoplasms arising from within the brain or from systemic tumors that have metastasized to the brain. This article focuses on the most recent findings with regard to epidemiology, clinical presentation, neuroimaging evaluation, and diagnosis of brain tumors.

RECENT FINDINGS

Patients with brain tumors may present for care with a variety of signs and symptoms. The most frequent clinical presentations include seizure, headache, fatigue, and cognitive dysfunction. Currently, diagnosis and treatment response is largely evaluated by using MRI. However, molecular imaging may ultimately be better suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered in treatment. Contemporary neuropathology continues to play a key role in the multidisciplinary management of patients with brain tumors. Genetic and environmental risk factors for brain tumors remain largely unclear.

SUMMARY

Brain tumors represent a diverse spectrum of highly morbid cancers arising from different cells both from within the brain and from systemic tumors that have metastasized to the brain. The clinical manifestations of intracranial tumors are usually referable to the anatomic area of the brain involved or adjacent structures. The initial diagnosis of intracranial tumors is most efficiently made by imaging, generally MRI, although other techniques are being explored. The clinical manifestations, neuroimaging evaluation, and diagnosis of brain tumors are varied and dependent on the specific manner in which a patient presents for care. To date, specific causes of brain tumors remain elusive.

摘要

综述目的

脑肿瘤是起源于脑内或已转移至脑的全身肿瘤的一组肿瘤。本文重点关注脑肿瘤在流行病学、临床表现、神经影像学评估及诊断方面的最新研究结果。

最新研究结果

脑肿瘤患者就诊时可能出现多种体征和症状。最常见的临床表现包括癫痫发作、头痛、疲劳及认知功能障碍。目前,主要通过磁共振成像(MRI)评估诊断及治疗反应。然而,分子成像最终可能更适合通过量化细胞代谢、增殖及凋亡(这些在治疗中会改变的活动)来测量早期反应。当代神经病理学在脑肿瘤患者的多学科管理中继续发挥关键作用。脑肿瘤的遗传和环境风险因素在很大程度上仍不明确。

总结

脑肿瘤是源自脑内不同细胞以及已转移至脑的全身肿瘤的一系列高致病性癌症。颅内肿瘤的临床表现通常与受累脑区或相邻结构有关。颅内肿瘤的初步诊断最有效地通过成像(通常为MRI)进行,尽管也在探索其他技术。脑肿瘤的临床表现、神经影像学评估及诊断各不相同,且取决于患者就诊的具体方式。迄今为止,脑肿瘤的具体病因仍不清楚。

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