Fine H A, Mayer R J
Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115.
Ann Intern Med. 1993 Dec 1;119(11):1093-104. doi: 10.7326/0003-4819-119-11-199312010-00007.
To compare the pathogenesis, clinical presentation, therapy, and prognosis of primary central nervous system lymphoma in immunocompetent persons with these characteristics of the disease in patients with AIDS.
All English-language papers published between 1980 and 1992 dealing with either lymphoma and the central nervous system or AIDS were reviewed. Patient characteristics, clinical presentation, histologic findings, and treatment and survival data were extracted from each case report and review.
Data were available on 792 patients (from 40 reported series) with non-AIDS-associated primary central nervous system lymphoma and 315 patients (from 32 series) with AIDS-associated primary central nervous system lymphoma. Patients with AIDS initially consulted a physician more often when they had global neurologic symptoms compared with patients without AIDS, with more than 50% of the lesions on computed tomographic (CT) scans in patients with AIDS being ring-enhancing and multifocal, a pattern rarely described in immunocompetent patients. The overall survival of the patients without AIDS was 18.9 months compared with 2.6 months for patients with AIDS, with substantial differences remaining even for subgroups of patients similarly treated with radiation and chemotherapy.
Primary central nervous system lymphoma is probably a substantially different disease in persons with and without AIDS with regard to patient characteristics, clinical and radiographic presentation, and prognosis. Recent advances in the treatment of this disease in patients without AIDS have not largely affected patients with AIDS. Substantial improvements in survival in these patients await advances in controlling their human immunodeficiency virus-associated disease.
比较免疫功能正常者与艾滋病患者原发性中枢神经系统淋巴瘤的发病机制、临床表现、治疗方法及预后。
回顾了1980年至1992年间发表的所有涉及淋巴瘤与中枢神经系统或艾滋病的英文论文。从每个病例报告和综述中提取患者特征、临床表现、组织学发现以及治疗和生存数据。
有792例（来自40个报道系列）非艾滋病相关原发性中枢神经系统淋巴瘤患者和315例（来自32个系列）艾滋病相关原发性中枢神经系统淋巴瘤患者的数据。与非艾滋病患者相比，艾滋病患者出现全身性神经症状时更常去看医生，艾滋病患者计算机断层扫描（CT）上超过50%的病灶呈环状强化且为多灶性，这种模式在免疫功能正常的患者中很少见。非艾滋病患者的总生存期为18.9个月，而艾滋病患者为2.6个月，即使是接受类似放疗和化疗的亚组患者也存在显著差异。
原发性中枢神经系统淋巴瘤在艾滋病患者和非艾滋病患者中，在患者特征、临床和影像学表现以及预后方面可能是截然不同的疾病。非艾滋病患者该疾病治疗的最新进展对艾滋病患者影响不大。这些患者生存的显著改善有待于控制其与人类免疫缺陷病毒相关疾病方面的进展。
