脑胶质瘤患者预后相关影响因素分析  

Analysis of factors related to prognosis in patients with glioma

作　　者：曾剑平[1] 刘青 林志雄[3] 贺军华[1] 张新文[1] 金心[1] 

机构地区：[1]浙江省立同德医院神经外科,杭州310012 [2]杭州市滨江医院生殖内分泌科 [3]北京三博脑科医院神经外科

出　　处：《临床神经外科杂志》2015年第6期410-414,共5页Journal of Clinical Neurosurgery

摘　　要：目的探讨影响脑胶质瘤患者预后的相关因素,为临床更准确地判断胶质瘤患者预后提供参考。方法回顾性分析浙江省立同德医院神经外科同一医疗组81例资料齐全的脑胶质瘤患者的临床资料,利用Cox比例风险模型进行预后相关因素的判定,以P<0.05为统计学判定标准。结果 Cox比例风险模型分析提示:术前KPS评分、年龄、肿瘤病理分级、术后放疗、替莫唑胺使用疗程、Ki-67表达对胶质瘤患者的预后有影响。结论年龄、肿瘤级别、术前KPS评分、术后放疗、Ki-67表达水平是脑胶质瘤患者的预后影响因素。年龄越大、病理分级越高、Ki-67表达水平越高、术前KPS评分越低者预后越差。术后进行放疗以及足够疗程的替莫唑胺化疗将有助于改善胶质瘤患者的预后。Objective To analyze the relationship between clinical factors and prognosis in brain glioma in order to provide the theoretical reference for prognosis and treatment for glioma patients. Methods The clinical data of 81 patients with brain glioma treated in our hospital from January 2002 to November 2011 were analyzed retrospectively. The prognosis was analyzed by Cox multivariate model. P 〈 0.05 indicated that the factor was related to the survival. Results Through Cox/s multivariate logistic regression analysis, 6 factors might be related to the prognosis of patients with glioma, including preoperative Karnosky Performance Scale （ KPS ） score, age, pathological grading, postoperative radiotherapy, the courses of treatment of temozolomide （TMZ） and the expression level of Ki-67. Conclusions Age,pathology grade,preoperative KPS score,postoperative radiotherapy and the expression level of Ki-67 are independent factors which might affect the prognostic of patients with glioma. The patients with older age,lower preoperative KPS, higher pathological grade and higher level of Ki-67 have poorer prognosis. Postoperative radiotherapy and enough adequate chemotherapy using TMZ will be helpful to improve the prognosis of glioma.

关 键 词：胶质瘤 生存分析 预后 

分 类 号：R651.1[医药卫生—外科学]