脑膜癌病的脑脊液细胞学诊断相关因素研究

目的 探讨影响脑膜癌病脑脊液细胞学诊断的相关因素。方法 回顾性分析46例脑膜癌病患者的临床资料。结果 46例脑膜癌病的脑脊液中，38例发现瘤细胞(约82．6％)；40例腰穿脑脊液中，35例检到瘤细胞；6例脑室穿刺脑脊液中，3例检到瘤细胞；35例腰穿脑脊液检到瘤细胞中，26例为第一次检到瘤细胞，5例第2次检到瘤细胞，3例第3次检到瘤细胞，l例3次以上检到瘤细胞；6例硬脑膜-蛛网膜强化者仅l例脑脊液细胞学检到瘤细胞；4例软脑膜-蛛网膜强化者脑脊液细胞学均检到瘤细胞；38例原发肿瘤中，19例血液系统肿瘤(白血病、淋巴瘤)均检到瘤细胞，7例肺癌检出4例，5例胃癌检出3例，4例乳腺癌检出2例，1例室管膜瘤全部检出，1例脑淋巴瘤全部检出。结论常规脑脊液细胞学检查具有较高的特异性，脑脊液的来源、腰穿检查的次数、脑膜癌病病变的位置、原发肿瘤及组织类型均为影响其敏感性的重要因素。

Study of the related factors in the diagnosis of cerebrospinal fluid cytology in meninges metastasis

Objective To investigate the factors influencing the diagnosis of cerebrospinal fluid cytology in meninges metastasis.Methods Retrospectively review the clinic datas of meninges metastasis in 46 cases.Result Malignant cells are found in 38 cases on rountine cerebrospinal fluid cytologic examination (about 82.6%).35 of 40 cases were in the cerebrospinal fluid of the lumbar puncture and 3 of 6 cases in the cerebrospinal fluid of the cerebral ventricle puncture.Of the 35 cases in the cerebrospinal fluid by the lumbar puncture,26 cases were found in the first examination,5 cases in the second,3 cases in the third and 1 cases in the third over.Malignant cells in cerebrospinal fluid cytology can be found in only 1 cases of dura-arachno reinforcement and all 4 cases of pia mater and ependyma.The primary tumors of the Malignant cells in the cerebrospinal fluid were leukemia,lymphoma,pulmonary carcinoma,stomach cancer, mammary cancer and ependymoma.Conclusion Routine cerebrospinal fluid cytologic examination has high specificity.Many factors can influence the sensibitity such as the resource of cerebrospinal fluid,the times of the examination,the site of lesion, the primary tumor and pathologic type.