Gao Naisheng, Xin Tao
Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
Zhongguo Fei Ai Za Zhi. 2022 Jul 20;25(7):517-523. doi: 10.3779/j.issn.1009-3419.2022.102.25.
Leptomeningeal metastases (LM), a special type of metastasis in advanced lung cancer, is known for its severe clinical symptoms, rapid progression and poor prognosis. LM used to be featured with low clinical diagnosis rate, limited treatment options, poor treatment efficacy, and very short survival if treatment not given. Though cerebrospinal fluid (CSF) cytology remains to be the gold standard for the diagnosis of LM, the positive rate of the first CSF cytology even in patients with suggestive clinical symptoms and positive imaging generally does not exceed 50%, leading to a delay in the diagnosis and treatment of patients with LM. With the progress of targeted therapy for driver gene-positive lung cancer and immunotherapy for driver gene-negative lung cancer, the overall survival of patients with lung cancer has been prolonged, meanwhile incidence of LM has been increasing year by year. Current clinical research in this field center around how to improve diagnosis rate and to find effective treatment approaches. This paper reviews advances in diagnosis and treatment of LM of lung cancer.. .
软脑膜转移(LM)是晚期肺癌的一种特殊转移类型,以其严重的临床症状、快速进展和不良预后而闻名。LM过去的特点是临床诊断率低、治疗选择有限、治疗效果差,如果不进行治疗,生存期很短。虽然脑脊液(CSF)细胞学检查仍然是诊断LM的金标准,但即使在有提示性临床症状和影像学阳性的患者中,首次CSF细胞学检查的阳性率一般也不超过50%,导致LM患者的诊断和治疗延迟。随着驱动基因阳性肺癌靶向治疗和驱动基因阴性肺癌免疫治疗的进展,肺癌患者的总生存期得到了延长,同时LM的发病率也逐年增加。目前该领域的临床研究主要围绕如何提高诊断率和寻找有效的治疗方法展开。本文综述了肺癌LM诊断和治疗的进展。