Glass J P, Melamed M, Chernik N L, Posner J B
Neurology. 1979 Oct;29(10):1369-75. doi: 10.1212/wnl.29.10.1369.
We reviewed the correlation between malignant cells in cerebrospinal fluid (CSF) (positive cytology) and pathologic findings at autopsy. The purpose was to discover: (1) the incidence of negative CSF cytology in patients with CNS malignancy, (2) the incidence of false-positive cytology, and (3) the relationship between a true-positive cytology and the distribution of malignant tumor at autopsy. Of 117 patients with CNS tumor and premortem cytologic examination of the CSF, 31 (26 percent) were positive and 86 (74 percent) were negative. Only 1 of 66 patients with tumor that did not reach the leptomeninges had a positive cytology. Of 51 patients with leptomeningeal tumor at autopsy, cytology was positive in 30 (59 percent) and negative in 21 (41 percent). Five potentially "false-positive" cytologies were encountered: three patients were treated, and tumor may have been eradicated; in two patients with lymphoma, inflammatory cells associated with infection were apparently mistaken for malignant cells. These data indicate that a positive CSF cytology is a reliable indicator of CNS malignancy and almost always reflects leptomeningeal tumor.
我们回顾了脑脊液（CSF）中的恶性细胞（细胞学检查阳性）与尸检病理结果之间的相关性。目的是发现：（1）中枢神经系统（CNS）恶性肿瘤患者脑脊液细胞学检查阴性的发生率；（2）细胞学检查假阳性的发生率；（3）细胞学检查真阳性与尸检时恶性肿瘤分布之间的关系。在117例接受过脑脊液生前细胞学检查的CNS肿瘤患者中，31例（26%）为阳性，86例（74%）为阴性。在66例肿瘤未累及软脑膜的患者中，只有1例细胞学检查呈阳性。在51例尸检时有软脑膜肿瘤的患者中，30例（59%）细胞学检查为阳性，21例（41%）为阴性。发现了5例假阳性细胞学检查结果：3例患者接受了治疗，肿瘤可能已被根除；在2例淋巴瘤患者中，与感染相关的炎性细胞显然被误认为是恶性细胞。这些数据表明，脑脊液细胞学检查阳性是CNS恶性肿瘤的可靠指标，几乎总是反映软脑膜肿瘤。
