脑胶质瘤患者术后复发的相关影响因素探讨  

Sutdy on postoperative recurrence and influencing factors of recurrence for brain glioma

作　　者：张眉[1] 裘五四[1] 姜启周[1] 

机构地区：[1]杭州师范大学附属医院神经外科,浙江杭州310015

出　　处：《中国现代医生》2013年第22期11-13,共3页China Modern Doctor

基　　金：浙江省自然科学基金(Y2080913)

摘　　要：目的对脑胶质瘤患者术后复发情况进行观察,并对可能影响复发相关因素进行分析。方法回顾性分析我院进行手术治疗的211例脑胶质瘤患者,追踪观察术后10年期间的复发情况,对可能影响复发的相关单因素、多因素回归分析。结果 211例患者术后复发183例,183例中137例在1年内复发,其1年内复发率为64.93%(137/211),38例在2年内复发,第2年复发率为18.01%(38/211),4例在3年内复发,第3年复发率为1.90%(4/211),2例在第5年复发,2例在第8年复发。本研究首先通过生存单因素分析,筛选出可能7个影响胶质瘤复发的因素:年龄、症状持续时间、术前KPS评分、病理分级、切除程度、术后综合治疗、PCNA的表达。而进一步的多因素分析结果显示:年龄、术前KPS评分、病理分级、术后放化疗综合治疗与术后复发时间长短的相关性具有统计学意义(P<0.05)。其中病理分级对复发时间影响最大。结论脑胶质瘤患者术后第1年内复发率高,病理分级是影响胶质瘤复发时间的主要危险因素,年龄越小、术前KPS评分越高者越有利于长期生存,手术放疗联合化疗可以明显延长术后复发时间。Objective To observe the postoperative recurrence of brain glioma to analyze the influencing factors of recurrence. Methods Retrospectively analyzed the clinical data of 211 patients with brain glioma, followed the patients for a total of 10 years and analyzed the postoperative recurrence by single factor and multiple regression analysis. Results Of the 211 patients, 183 cases relapsed, included 137 cases relapsed within 1 year, the recurrence rate was 64.93% （137/211）; 38 cases relapsed within 2 years, the recurrence rate was 18.01% （38/211）, 4 eases relapsed within 3 years, the recurrence rate was 1.90%（4/211 ）, 2 cases relapsed in the fifth year, 2 cases relapsed in the eighth year. First of all, through the survival single factor analysis, the study screened out seven influencing factors of recurrence for brain glioma：age, duration of symptoms, preoperative KPS score, pathological grading, extent of resection, postoperative comprehensive therapy, and the expression of PCNA. The further multifactor analysis showed： age, preoperative KPS score, pathological grading, postoperative chemoradiation therapy and time of postoperative recurrence had significant differences（P 〈 0.05 ）. Among them, the pathological grading greatest influenced the recurrence. Conclusion The recurrence rate of postoperative patients with cerebral glioma is high in the first year, pathology grading is the main risk factor of recurrent time, the younger and higher preoperative KPS score, the more conducive to long-term survival, radiotherapy combined with chemotherapy can significantly prolong the time of postoperative recurrence.

关 键 词：脑胶质瘤 复发时间 因素 

分 类 号：R574.205[医药卫生—消化系统]