原发性脑淋巴瘤定向活检与手术及联合治疗的选择  

The Alternative Therapeutic Alliance of Stereotaxic Biopsy and Operation in Primary Brain Lymphoma

作　　者：李明洙[1] 罗力[1] 富春雨[1] 高乃康[1] 窦长武[1] 王涛[1] 李云霞[1] 

机构地区：[1]内蒙古医学院附属医院神经外科普外科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2008年第11期1281-1284,共4页Inner Mongolia Medical Journal

摘　　要：目的：由影像表现结合临床制定定向活检、手术选择联合治疗方案。方法：回顾1999～2003年6组PMLB101例进行临床分析，依MR、CT表现病灶部位分布为基础，制定可供活检、手术切除、联合治疗选择的5种类型。结果：Ⅰ型，大脑半球浅部、皮质下单发型：手术切除＋放疗、化疗。Ⅱ型，大脑半球深部单发型（中线、侧脑室壁、底节区）：定向活检／酌情手术＋放疗、化疗。Ⅲ型，小脑单发型（含CPA）：手术切除＋放疗、化疗。Ⅳ型，人脑半球多发型；定向活检＋放疗、化疗。Ⅴ型，大幕上下弥散型（含脑表面、脑干）：定向活检／CSF瘤细胞检查＋放疗、化疗。结论：按分型结合病人状态选择定向活检、手术切除、放疗、化疗联合方案。不能一律避讳手术治疗，要强调权衡利弊实施联合治疗、规范施行化疗方案，观察研究改善给药方法提高药效；对国内可诱发PMLB危险人群发病要引起关注研究。Objective： To Work out an unitetherapy plan of surgery and stereo biopsy which hase on expression of images. Methods： To analysis 101 cases of primary malignant lymphoma of tile brain（PMLB）, which range from 1999 to 2003, five types cases that could be taken by biopsy, surgical intervention and unite therapy were classified based on its image materials. Results： typei Ⅰ, Solitary tunor that waslocaled on superficial and subcortical cerebral hemisphere, these cases could be treated by surgicalintervention plus radiation therapy and chemotherapy, type Ⅱ ：Solitary tumor which was located on deepdparts of cerebral hemisphere（the median line, the walls of lateral ventricle, basal ganglia）, these cases could be treated by stereo biopsy or surgery plus radiation therapy and chemotherapy, type Ⅲ ： solitary tumor in cerebellum（including CPA）which could be treared by surgical intervent ion plus radiation therapy and chemotherapy, type Ⅳ ： multiple tumors in cerebral hemisphere which could be treated by stereo biopsy plus radiation therapy and chemotherapy, typer Ⅴ ： diffuse type superiol and inferior the tentorium（including the surface of brain and brain stem）which could be treated by sltereo biopsy or cytological examination of CSF plus radiation therapy and chemotherapy. Conclusions： The unite - therapy plan of stereo biopsy, surgical intervention, radiation therapy and chemotherapy should be work out based on type and patient＇s siturators. We should emphasize the unite-therapy after balance advantages and disadvantages while should not obviate the surgery with exception. The chemotherapy should be regularized, and the ways of medi cation must be observed and studied so as to increase the curative effect. The civilcrowd of exposure , which could be evoked PMLB shoutd be mentioned and explored.

关 键 词：脑淋巴瘤 定向活检 联合治疗选择 类型 

分 类 号：R739.41[医药卫生—肿瘤]