A Retrospective Analysis Of The Diagnosis And Treatment Of Primary Central Nervous System Lymphoma

BACKGROUND & OBJECTIVE: Primary central nervous system lymphoma(PCNSL)is a rare malignant tumor of the central nervous system.Its incidence has been continuously increasing in recent years,but due to its lack of specificity imaging findings and laboratory findings are often difficult to diagnose before surgery,and because of its aggressive nature,there are no effective treatment options after surgery and the prognosis is not ideal.By summarizing and analyzing the above features of PCNSL,the clinical diagnosis and treatment of the disease will be improved,providing a reference for relevant research.Methods: Retrospective analysis of the 35 patients with pathologically confirmed PCNSL admitted to our hospital during the period from September 2014 to April 2018 at the Department of Neurosurgery,the First Hospital of Jilin University.The patient’s age,gender,duration,clinical data,performance,KPS scores,auxiliary examinations,treatment data,pathology data,and patient prognosis data were collected.And systematic analysis of them.Results: Among the 35 patients,there were 17 males and 18 females.No history of organ transplantation,malignant neoplasms and autoimmune diseases were found.HIV antibody tests were negative.The male to female ratio was 0.9:1;aged 26-78 years.The median age is 58,and the average age is 56.5,14 cases were older than 60 years,and 21 cases were below 60 years old(including 60 years old).Most of the clinical manifestations are symptoms of increased intracranial pressure as the main symptoms.The preoperative KPS score was >70 in 31 patients,and KPS <70 in 4 patients.Through head scans and enhanced MRI.There were 26 single lesions,9 multiple lesions,and most involved the supratentorial.Immunohistochemistry showed that 34 B cells were the source and 1 was the source of T cells.Statistical analysis showed that the survival time was longer in patients with single lesion,postoperative radiotherapy or chemotherapy after surgery than the patients with multiple lesions,surgery alone and postoperative radiotherapy and chemotherapy after surgery.Conclusions: 1.The prognosis of patients with PCNSL was not related to the age of the patients,preoperative KPS scores,single or multiple lesions,and gender.2.The prognosis of patients with PCNSL is related to the location and treatment of the lesion.The prognosis of multiple lesions was poorer than that of single lesions,and the prognosis of single lesions located on the supratentorial site was better than that of single lesions located on subtentorial.Postoperative radiotherapy alone was superior to postoperative chemotherapy alone.The prognosis of patients undergoing single radiotherapy or chemotherapy was better than that of postoperative radiotherapy and chemotherapy.3.Surgical treatment alone can only alleviate clinical symptoms.If combined with radiotherapy and chemotherapy after surgery can significantly prolong patient survival.However,the prognosis of patients receiving radiotherapy and chemotherapy combined therapy was significantly lower than that of a single radiotherapy or chemotherapy regimen.Careful consideration should be given when formulating a treatment plan for patients with PCNSL.