脑胶质瘤预后影响因素分析  

Analysis of Prognostic Factors of Brain Glioma

作　　者：白庆岭[1] 胡长伟[1] 彭营影 姚玉芳 王希瑞[1] 赵志煌[1] 韩永刚 BAI Qing-ling;HU Chang-wei;PENG Ying-ying;YAO Yu-fang;WANG Xi-rui;ZHAO Zhi-huang;HAN Yong-gang(Department of Neurosurgery Cangzhou Central Hospital,Cangzhou,Hebei 061000,Chin;Department of Neurology,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院神经外科,河北沧州061000 [2]沧州市中心医院神经内科,河北沧州061000

出　　处：《临床误诊误治》2018年第7期91-94,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省自然科学基金项目(20151666)

摘　　要：目的探讨脑胶质瘤患者预后相关影响因素,为临床制定更准确的治疗方案提供理论依据。方法回顾性分析沧州市中心医院2013年1月—2016年6月收治脑胶质瘤93例的临床资料,探讨影响患者预后的相关因素。结果本组发病男性略多于女性,以突发四肢抽动、头痛乏力、呕吐、视力改变、语言障碍为主要临床症状,恶性程度高,预后较差,随防至2017年10月生存率为54.84%。预后单因素分析显示:年龄、肿瘤分级、术前行为状态量表(KPS)评分、手术方式、术后行放化疗、术后使用替莫唑胺(TMZ)疗程是脑胶质瘤患者预后的影响因素;多元Cox逐步回归分析显示:患者高龄(年龄≥60岁)、高级别肿瘤、肿瘤部分手术切除、术前KPS评分<70分、术后未行放化疗及术后使用TMZ<4个疗程是脑胶质瘤患者预后的独立危险因素。结论脑胶质瘤初期症状不典型,恶性程度高,预后差;患者年龄越大、肿瘤分级越高、肿瘤部分手术切除、术前KPS评分越低患者预后越差,术后给予放化疗并使用多疗程的TMZ治疗能延长患者生存期。Objective To analyze prognostic factors in patients with brain glioma,thereby providing theoretical basis for the development of more accurate treatment plan in clinical practice.Methods Clinical data and follow-up data of 93 cases of brain gliomas in Canzhou Central Hospital from January 2013 to June 2016 were retrospectively analyzed,to explore related prognostic factors.Results The incidence of this disease was slightly higher in males than in females.The main clinical symptoms included sudden limb twitching,headache,fatigue,vomiting,altered visual acuity,and language communication disorders,with a high degree of malignancy and poor prognosis.They were followed up until October 2017,and the 2-year survival rate of this group was 54.84%.According to univariate analysis of brain glioma in 93 cases,age,tumor grade,preoperative KPS score,operation methods,postoperative chemoradiotherapy,postoperative use of temozolomide(TMZ)treatment were the prognostic factors of patients with brain glioma.Multivariate Cox regression analysis showed that elderly patients(aged 60 or older),high grade tumors,partial tumor resection and preoperative KPS score<70 points,no postoperative chemoradiotherapy and TMZ<4 courses after surgery were independent risk factors for the prognosis of glioma patients.Conclusion Early symptoms of brain glioma are not typical,with a high degree of malignancy and poor prognosis.The older patients,the higher tumor grade,partial tumor resection,lower preoperative KPS score contribute to worse prognosis of TMT patients.Postoperative chemoradiotherapy coupled with multiple courses of TMT treatment can prolong the survival of patients.

关 键 词：脑胶质瘤 预后 影响因素分析 

分 类 号：R739.4[医药卫生—肿瘤]