非免疫缺陷原发性中枢神经系统淋巴瘤１７例临床分析

目的　探讨非免疫缺陷原发性中枢神经系统淋巴瘤（ＰＣＮＳＬ）的诊治特点。方法　回顾分析２００６年３月至２００９年４月经病理组织学证实且免疫功能正常的１７例ＰＣＮＳＬ患者的临床资料。１３例手术完全或部分切除，４例行立体定向活检术；术后１５例给予化疗和放疗，２例未行放化疗。化疗采用大剂量甲氨喋呤（ＨＤ-ＭＴＸ）２.０ｇ／ｍ^２静滴，每周１次，连用３周；第４周开始放疗，６例脑脊液异常者行全中枢神经系统放疗，９例脑脊液正常者仅行全脑放疗。结果　６例ＨＤ-ＭＴＸ加全中枢神经系统放疗中５例（８３.３％）出现３级白细胞减少，未出现其他３级以上毒副反应。随访９～４６个月，２例未行放化疗者术后１个月复发；１５例行放化疗中１例术后３个月复发，１例失访，１３例未复发存活，２年生存率６９.２％。结论　ＰＣＮＳＬ临床表现缺乏特异性，确诊依赖于病理诊断；手术仅有诊断意义，采用ＨＤ-ＭＴＸ化疗联合放疗的综合治疗模式可提高疗效及生存率，且相对安全。

Clinical analysis of 17 cases of primary central nervous system lymphoma

Objective To investigate the clinical manifestations of primary central nervous system lymphoma(PCNSL)and explore the effective methods of diagnosis and treatment for immunocompetent PCNSL patients.Methods The clinical,laboratory,imaging and pathological data from 17 cases with PCNSL in our hospital from March 2006 to December 2008 were analyzed.Four patients received stereotactic brain biopsy while the other were given surgical treatment.Fifteen patients were received both radiotherapy and chemotherapy aft...