非小细胞肺癌脑膜转移的诊疗进展.PDFVIP

中国癌症杂志 2017年第27卷第7期 《 》 CHINA ONCOLOGY 2017 Vol.27 No.7 593 非小细胞肺癌脑膜转移的诊疗进展 张　帅 综述，别志欣 审校 北京医院国家老年医学中心肿瘤内科，北京 100730 　　［摘要］　脑膜转移是非小细胞肺癌的严重并发症，其临床表现不特异，主要包括脑实质受累、颅神经及 脊髓、脊神经根刺激症状。诊断主要依据肿瘤病史、临床表现、影像学及脑脊液检测。EGFR-TKIs等靶向治疗 药物应用于选择人群可能存在生存获益，但目前其总体治疗效果仍不满意，预后差。本文就非小细胞肺癌脑膜 转移的流行病学、病理生理、临床表现、诊断方法及治疗疗效的研究进展进行综述。 　　 ［关键词］　非小细胞肺癌；脑膜转移；诊断；治疗 　　DOI: 10.19401/ki.1007-3639.2017.07.012 　　 中图分类号：R734.2　　文献标志码：A　　文章编号：1007-3639(2017)07-0593-08 Advances in the diagnosis and therapies of leptomeningeal metastasis in non-small cell lung cancer ZHANG Shuai, BIE Zhixin (Department of Medical Oncology, National Center of Gerontology, Beijing Hospital, Beijing 100730, China) Correspondence to: BIE Zhixin E-mail: zhxbiejn@ Abstract Leptomeningeal metastasis (LM) is a serious fatal complication of non-small cell lung cancer 　　［ ］ (NSCLC), which is lack of specificity in clinical manifestations. Symptoms and signs are classically divided into three domains of neurological function: cerebral hemisphere, cranial nerve and spinal cord, and exiting nerve roots. Apart from a clinical suspicion of LM, diagnosis is based on demonstration of cancer in cerebrospinal fluid or radiograph- ic manifestations as revealed by neuraxis imaging. Although the novel agents including targeted therapies such as EGFR-TKIs have conferred a survival benefit in selected NSCLC patients in some studies, the prognosis is still poor. This review focuses on the pathologic physiology, clinical manifestations, diagnosis and therapies of LM in NSCLC. Key words Non-small cell lung cancer; Leptomeningeal metastasis; Diagnosis; Therapy 　［ ］ 　　肺癌是我国目前常见的恶性肿瘤之一，每年