影响人脑恶性胶质瘤预后因素的研究  

Prognostic Factors for Patients with Malignant Glioma

作　　者：漆松涛[1] 刘承勇[1] 俞方毅[1] 邱炳辉[1] 

机构地区：[1]南方医科大学南方医院神经外科,广东广州510515

出　　处：《中国神经肿瘤杂志》2006年第3期209-214,共6页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:影响人脑恶性胶质瘤预后的因素众多,本文通过总结我们的临床病例,分析影响人脑恶性胶质瘤预后的因素。方法:收集自2003年10月至2004年4月在南方医科大学附属南方医院神经外科手术治疗的67例恶性胶质瘤患者的资料。生存分析单因素使用Kaplan-Meier法计算生存率并采用对数秩(log-rank)检验;多因素分析使用Cox比例风险模型,采用逐步回归分析。结果:单因素分析结果显示术前癫痫、肿瘤分化程度、肿瘤范围、术中病理标示肿瘤向周边侵袭性生长程度、手术切除程度及术后个体化综合治疗等因素与患者预后有关(P<0.05);多因素分析示手术切除范围、术后个体化综合治疗、肿瘤侵袭性生长程度、肿瘤的分化程度则是影响无瘤生存的独立因素。年龄、性别、KPS评分、肿瘤体积等因素两种分析均未发现与预后有关。结论:手术切除范围、术后个体化综合治疗、肿瘤侵袭性生长程度、肿瘤的分化程度对预后影响较大;而术前癫痫、肿瘤范围对判断预后价值有限;患者的年龄、性别、KPS评分、肿瘤体积与预后无关。BACKGROUND ＆ OBJECTIVE： There were many factors affect prognosis of patients with gliomas. This article, through reviewing our clinical data, analyze the prognostic factors of malignant gliomas. METHODS： Data of 67 patients with malignant glioma, treated in our institute from October 2003 to April 2004 were analyzed. Survival probabilities were estimated based on Kaplan-Meier＇s survival analysis and Log rank test for the univariate analysis. Cox＇s proportional-hazards model was used for multivariate regression analysis to show the simultaneous effect of outcome-related variables on survival. RESULTS： Univariate analysis demonstrated that epilepsy before surgery, histologic grade, tumor location and extension, extent of resection, individually comprehensive therapy were the significant factors for survival （P〈0.05）. Multivariate survival analysis showed that extent of resection, individually comprehensive therapy, tumor extension, histological grade were independent, statistically significant prognostic factors for patients with malignant glioma. Whereas age, gender, Karnofsky score of the patient, bulk of tumor did not show significance effect on survival of the patients. And patient age, gender, Kamofsky score, bulk of tumor had no association with patient survival on both univariate and multivariate analysis. CONCLUSION： Extent of resection, individually comprehensive therapy, tumor extension, histological grade are associated strongly with survival of the malignant gliomas, while preoperative epilepsy and tumor location appear to be of limited prognostic value. There is no correlation between patient age, gender, Kamofsky PS score, bulk of tumor and survival.

关 键 词：恶性胶质瘤 预后 因素分析 治疗方案 

分 类 号：R739.41[医药卫生—肿瘤]