影响颅内室管膜瘤患者预后的相关因素分析(附156例报告)  

Analysis of related factors affecting the outcomes of patients with intracranial ependymomas:A report of 156 cases

作　　者：张鹏[1] 赵海彪 王蒙[1] 孙红卫[1] 刘献志[1] 张振宇[1] Zhang Peng;Zhao Haibiao;Wang Meng;Sun Hongwei;Liu Xianzhi;Zhang Zhenyu(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经外科,450052

出　　处：《中华神经外科杂志》2020年第6期593-596,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(81702465,U1804172);河南省教育厅项目(18A320059)。

摘　　要：目的探讨影响颅内室管膜瘤患者术后预后的相关因素。方法回顾性分析2011年1月至2017年12月在郑州大学第一附属医院神经外科首次行手术治疗的156例颅内室管膜瘤患者的临床资料。采用Kaplan-Meier法分析患者的性别、年龄、术前Karnofsky功能状态评分(KPS),肿瘤的部位、世界卫生组织(WHO)分级、切除程度及术后是否化疗和放疗对总生存期(OS)和无进展生存期(PFS)的影响,对差异有统计学意义的指标采用多因素Cox回归分析方法分析影响患者生存的独立因素。结果156例患者,随访时间为4.5~84.0个月,中位数为33.5个月。末次随访时死亡36例(23.1%);存活120例(76.9%),其中未复发96例(80.0%),复发24例(20.0%)。5年总体生存率为78.2%(122/156),无进展生存率为62.2%(97/156)。多因素Cox回归分析显示,术前KPS、肿瘤的WHO分级、肿瘤切除程度是OS和PFS的独立影响因素(均P<0.05)。是否化疗仅在单因素分析时显示化疗者PFS长于未化疗者,差异有统计学意义(P=0.022)。结论肿瘤的病理学分级高、肿瘤未全切除及术前KPS较低是术后颅内室管膜瘤患者OS和PFS的独立危险因素。Objective To explore the related factors affecting the outcomes of patients with intracranial ependymomas.Methods The clinical data of 156 cases of ependymoma undergoing the first operation at Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2017 were analyzed retrospectively.The effects of sex,age,tumor location,pathological grade,tumor resection extent,preoperative KPS(Karnofsky performance status)score,postoperative radiotherapy and chemotherapy on progression free survival(PFS)and overall survival(OS)were analyzed with Kaplan-Meier method.Among the indicators with statistically significant differences,the independent factors affecting survival were determined with multivariate Cox regression analysis.Results In 156 patients,the follow-up time ranged from 4.5 to 84.0 months(median:33.5 months).At the last follow-up,36 patients(23.1%)died and 120 patients(76.9%)survived,of which 96 patients(61.5%)did not relapse and 24 patients(15.4%)relapsed.The 5-year OS was 78.2%(122/156)and 5-year PFS was 62.2%(97/156).The independent prognostic factors for OS and PFS were pathological grade,preoperative KPS score and tumor resection extent(all P<0.05).Only univariate analysis showed that the PFS of patients undergoing chemotherapy was longer than that of those without chemotherapy,and the difference was statistically significant(P=0.022).Conclusion High pathological grade,incompleteness of tumor resection and low preoperative KPS score are independent risk factors for OS and PFS in patients with ependymoma after surgery.

关 键 词：室管膜瘤 神经外科手术 预后 因素分析 统计学 

分 类 号：R739.41[医药卫生—肿瘤]