论文部分内容阅读
目的探讨实体肿瘤转移脑膜癌病的临床流行病学和临床特点。方法对本院2004年至2013年间收治的73例实体肿瘤转移脑膜癌病患者进行分析。结果其中肺癌来源28例(39.7%)、原发癌灶不明者27例(38.4%)、胃癌转移9例(12.3%)、乳腺癌3例(4%)、黑色素瘤2例(2.7%),鼻咽癌、卵巢癌、脑胶质瘤、盆腔畸胎瘤各1例(1.4%)。2009年至2013年5年间发病较2004年至2008年增加2.65倍。男女比例1:1.15,中位发病年龄56±12岁,男女发病年龄差异无统计学意义(P>0.05),农民占80%,患者主要分布在河北省南部,石家庄地区居多。伴发病中2型糖尿病发病率8.22%,较社区人群高(P<0.05)。入院后首次脑脊液细胞学(CSFC)检查发现肿瘤细胞者62例(88.57%)。接受鞘内化疗者17例(23.94%),对部分患者随访发现不接受鞘内化疗15例患者生存期7.53w(m 5.5~9.57w),鞘内化疗患者8例生存期25.00w(m14.14~35.86w),鞘内化疗明显延长生存期。住院期间死亡率6.94%。结论河北省南部尤其是石家庄地区实体肿痛转移脑膜癌发病率增加趋势,鞘内化疗是有效地治疗脑膜癌的方法。
Objective To investigate the clinical epidemiology and clinical features of solid tumor metastasis of meningeal carcinoma. Methods Totally 73 patients with metastatic meningeal carcinomas who were treated in our hospital from 2004 to 2013 were analyzed. Results There were 28 cases (39.7%) of primary lung cancer, 27 cases (38.4%) of unknown primary tumor, 9 cases (12.3%) of gastric cancer, 3 cases of breast cancer (4%), 2 cases of melanoma (2.7% , Nasopharyngeal carcinoma, ovarian carcinoma, glioma and pelvic teratoma in 1 case (1.4%). The incidence in the five years from 2009 to 2013 increased 2.65 times from 2004 to 2008. The ratio of male to female was 1: 1.15, the median age of onset was 56 ± 12 years. There was no significant difference in age of onset between men and women (P> 0.05). Peasants accounted for 80% of the total. The patients mainly distributed in southern Hebei Province and Shijiazhuang. Incidence of type 2 diabetes incidence of 8.22%, higher than the community population (P <0.05). 62 cases (88.57%) of the tumor cells were found after the first CSF CSF cytology examination. Among them, 17 cases (23.94%) received intrathecal chemotherapy and 15.3% (5.5-5.57w) of the 15 patients who did not receive intrathecal chemotherapy at follow-up. The survival time of 8 patients with intrathecal chemotherapy was 25.00w (m14). 14 ~ 35.86w), intrathecal chemotherapy significantly prolonged survival. The in-hospital mortality rate was 6.94%. Conclusion The incidence of meningioma in solid tumor metastasis increased in southern Hebei, especially in Shijiazhuang, and intrathecal chemotherapy was an effective method to treat meningeal carcinoma.