Harrison K M, Muss H B, Ball M R, McWhorter M, Case D
Cancer. 1985 Jun 15;55(12):2839-44. doi: 10.1002/1097-0142(19850615)55:12<2839::aid-cncr2820551222>3.0.co;2-b.
Myelography was performed on 78 patients with breast cancer who had signs or symptoms compatible with spinal cord compression. Of 42 patients (54%) with extradural defects, 21 (50%) had a complete block. All patients with positive myelograms (M+) had a positive bone scan and 41 of 42 (97%) had positive skeletal x-rays. Except for paraplegia, paraparesis, or a sensory level abnormality, signs and symptoms were usually not precise enough to accurately predict patients with cord lesions; however, back pain, paresthesias, and bladder or bowel dysfunction were significantly more common in M+ patients. Cerebrospinal fluid (CSF) protein was elevated in almost all M+ patients but also in approximately half of the M- group. Cytology and glucose analysis of CSF were not of value in predicting cord involvement. Response to treatment was better for patients with fewer sites of metastatic disease and a shorter time from diagnosis to treatment. There was no notable difference in survival between M+ and M- patients. Myelography remains the most precise tool for diagnosing spinal cord lesions. Unfortunately, the prognosis of patients with metastatic breast cancer is poor regardless of whether spinal cord compression is present.
对78例有脊髓压迫体征或症状的乳腺癌患者进行了脊髓造影。在42例（54%）有硬膜外缺损的患者中，21例（50%）出现完全性梗阻。所有脊髓造影阳性（M+）的患者骨扫描均为阳性，42例中有41例（97%）骨骼X线检查阳性。除截瘫、轻瘫或感觉平面异常外，体征和症状通常不够精确，无法准确预测脊髓病变患者；然而，背痛、感觉异常以及膀胱或肠道功能障碍在M+患者中明显更为常见。几乎所有M+患者的脑脊液（CSF）蛋白均升高，但M-组中约一半患者也有升高。脑脊液的细胞学和葡萄糖分析对预测脊髓受累无价值。转移病灶部位较少且从诊断到治疗时间较短的患者对治疗的反应更好。M+和M-患者的生存率无显著差异。脊髓造影仍然是诊断脊髓病变最精确的工具。不幸的是，无论是否存在脊髓压迫，转移性乳腺癌患者的预后都很差。
