毛细胞型星形细胞瘤的预后因素分析  

Analysis of prognostic factors of pilocytic astrocytomas

作　　者：罗似亮 吾太华[1] 邓少勇 李正阳[1] 马赞[1] 许锡镇[1] 苏世星[1] 左德献 Luo Siliang;Wu Taihua;Deng Shaoyong;Li Zhengyang;Ma Zan;Xu Xizhen;Su Shixing;Zuo Dexian(Department of Neurosurgery,Affiliated Brain Hospital of Medical College of Jinan University,Guangzhou 510510,China)

机构地区：[1]暨南大学医学院附属脑科医院(广东三九脑科医院)神经外科,广州510510

出　　处：《中华神经外科杂志》2018年第8期815-819,共5页Chinese Journal of Neurosurgery

摘　　要：目的 探讨影响毛细胞型星形细胞瘤患者预后的相关因素.方法 回顾性分析2005年1月至2011年8月暨南大学医学院附属脑科医院（广东三九脑科医院）神经外科收治的87例毛细胞型星形细胞瘤患者的临床资料.65例行全切除或近全切除,19例行大部分切除,3例行单纯活组织检查.采用Kaplan-Meier法进行生存率的估计,以Cox比例风险回归模型进行预后因素的分析.结果 87例患者的5年无进展生存率为70.0％,5年总生存率为89.3％.单因素分析结果显示,年龄（OR=1.1,95％ CI：1.0 ～ 1.1,P=0.001）、病变部位（OR=12.2,95％ CI：1.6 ～92.8,P=0.016）、肿瘤复发（OR=14.8,95％ CI：3.2 ～67.7,P=0.001）、肿瘤切除程度（OR =3.7,95％ CI：1.2～11.7,P=0.023）与毛细胞型星形细胞瘤患者的预后有关.Cox多因素分析结果显示,年龄≥19岁（OR =2 296.8,95％ CI：7.1～742 006.4,P=0.009）和肿瘤复发（OR=14.5,95％ CI：1.0 ～ 203.5,P=0.047）为影响毛细胞型星形细胞瘤预后的独立危险因素.结论 毛细胞型星形细胞瘤的总体预后较好,但年龄≥19岁和（或）肿瘤复发的患者预后不佳.Objective To investigate the prognostic factors in patients with pilocytic astrocytomas.Methods We retrospectively analyzed the clinical data of 87 patients with pilocytic astrocytomas including 84 undergoing tumor resection and 3 undergoing biopsy at Department of Neurosurgery,Affiliated Brain Hospital of Medical College of Jinan University from January 2005 to August 2011.The significance of prognostic variables in the survival expectancy was evaluated with Kaplan-Meier method and Cox proportional hazard regression model.Results The 5-year progression-free survival rate was 70.0％.The 5-year cumulative survival rate was 89.3％.Univariate analysis showed that age （OR=1.1,95％CI：1.0-1.1,P=0.001）,lesions site （OR =12.2,95％CI：1.6-92.8,P=0.016）,relapse （0R=14.8,95％CI：3.2-67.7,P=0.001） and extent of resection（OR =3.7,95％ CI：1.2-11.7,P =0.023） were related to patient＇s prognosis.Multivariate analysis showed that age ≥ 19 years old （OR =2 296.8,95％ CI：7.1-742 006.4,P =0.009） and recurrence （OR =14.5,95％ CI：1.0-203.5,P =0.047） were independent risk factors affecting the overall survival rate of pilocytic astrocytomas.Conclusion The overall prognosis of pilocytic astrocytomas seems relative good except for those with age ≥ 19 years old and/or tumor recurrence.

关 键 词：脑肿瘤 预后 危险因素 毛细胞型星形细胞瘤 复发 

分 类 号：R739.4[医药卫生—肿瘤]