[1]朱国华,麦麦提力·米吉提,李彦东,等.高级别胶质瘤的预后影响因素分析[J].临床神经外科杂志,2019,16(5):430-438.[doi:10.3969/j.issn.1672-7770.2019.05.013]
 ZHU Guo-hua,Maimaitili·Mijiti,LI Yan-dong,et al.Analysis of factors related to prognosis in patients with high-grade glioma[J].Journal of Clinical Neurosurgery,2019,16(5):430-438.[doi:10.3969/j.issn.1672-7770.2019.05.013]
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高级别胶质瘤的预后影响因素分析()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第5期
页码:
430-438
栏目:
论著
出版日期:
2019-10-15

文章信息/Info

Title:
Analysis of factors related to prognosis in patients with high-grade glioma
作者:
朱国华麦麦提力·米吉提李彦东王昀更·党木仁加甫
830054 乌鲁木齐,新疆医科大学附属第一医院神经外科
Author(s):
ZHU Guo-hua Maimaitili·Mijiti LI Yan-dong et al.
Department of Neurosurgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
关键词:
高级别胶质瘤预后影响因素
Keywords:
high-grade glioma prognosis factor analysis
分类号:
R739.41
DOI:
10.3969/j.issn.1672-7770.2019.05.013
文献标志码:
A
摘要:
【摘要】目的探讨影响高级别胶质瘤预后的相关因素。方法对新疆医科大学第一附属医院神经外科中心2013年1月—2015年12月,行手术切除的384例高级别胶质瘤患者的临床资料进行回顾性分析。排除非手术因素死亡,采用Kaplan-Meier法进行生存率分析,以及Cox比例风险回归模型进行预后多因素分析。结果本组患者中,WHO Ⅲ级164例,WHO Ⅳ级220例,均接受同组医生手术。术后接受放疗、化疗者分别为212例和243例。随访1年、3年的总体生存率分别为73.7%、17.1%;WHO Ⅲ级患者的1年、3年生存率分别为92.3%、29.5%,WHO Ⅳ级患者的1年、3年生存率分别为60.2%、11.7%。多因素分析显示术后辅助放疗、化疗显著提高高级别胶质瘤患者的生存率(P<0.05)。Cox比例风险回归模型分析显示,年龄>60岁(RR=1.701;P=0.016)、术前KPS评分<70分(RR=2.231;P<0.001)、WHO Ⅳ级(RR=2.181;P<0.001)、肿瘤未全切(RR=2.101;P<0.001)、术后未联合放化疗(RR=1.562;P=0.007),是影响高级别胶质瘤总体生存率的独立危险因素。而性别、肿瘤大小、有无坏死/囊变,总生存期差异均无统计学意义(均P>0.05)。年龄<60岁、术前KPS评分≥70分、WHO Ⅲ级胶质瘤、肿瘤全切、术后联合放化疗患者的总生存期较长。结论发病年龄<60岁、KPS≥70分、WHO级别低(Ⅲ级)、肿瘤全切、术后放化疗的高级别胶质瘤患者的预后较好;术后联合进行放化疗可以提高胶质瘤的疗效。
Abstract:
Abstract: ObjectiveTo investigate the factors affecting the prognosis of patients with high-grade glioma. MethodsThe data of 384 cases of high-grade gliomas surgically removed in the Department of Neurosurgery, the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2015 were analyzed retrospectively to exclude non-surgical deaths. The survival analysis was performed by using Kaplan-Meierand the Cox proportional hazard regression model was used for prognostic multivariate analysis. ResultsThere were 384 high-grade gliomas in this group, including 164 cases of WHO Ⅲ grade and 220 cases of WHO Ⅳ grade. All of them received surgery from the same group of doctors. Postoperative radiotherapy and chemotherapy were performed in 212 patients and 243 patients. At 1 and 3 years follow-up, the overall survival rates were 73.7% and 17.1%, respectively. The WHO Ⅲ grade 1 and 3 year survival rates were 92.3% and 29.5%, respectively. The WHO Ⅳ grade 1 and 3 years survival rates were 60.2% and 11.7%, respectively. Multivariate analysis showed that postoperative adjuvant radiotherapy and chemotherapy significantly improved the survival rate of high-grade glioma(P<0.05). Cox proportional hazard regression model analysis showed age>60 years(RR=1.701,P=0.016), preoperative KPS score <70 points (RR=2.231,P<0.001), WHO Ⅳ grade(RR=2.181,P<0.001) tumors were not completely resected(RR=2.101,P<0.001), and no postoperative radiochemotherapy(RR=1.562,P=0.007) was an independent risk factor for the overall survival of high-grade gliomas. There was no significant difference in gender, tumor size, necrosis/capsule change, and total stage(all P>0.05). Patients with age <60 years, preoperative KPS score ≥70, WHO Ⅲ grade glioma, total tumor resection, and postoperative combined chemoradiotherapy had longer overall survival(OS). ConclusionThe age of onset <60 years old, KPS score≥70, low WHO grade(Ⅲ), total tumor resection, postoperative radiotherapy and chemotherapy of glioma patients with good prognosis, combined with radiotherapy and chemotherapy can improve the efficacy of glioma.

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更新日期/Last Update: 2019-10-15