脑膜瘤术后复发生存分析:附176例报告  

Survival analysis of postoperative recurrence of meningioma:176 cases report

作　　者：黄冠又[1,2] 郝淑煜 王亮[1] 张力伟[1] 张俊廷[1] 吴震[1] HUANG Guan-you;HAO Shu-yu;WANG Liang;ZHANG Li-wei;ZHANG Jun-ting;WU Zhen(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100070 [2]贵州省贵阳市第二人民医院神经外科,550081

出　　处：《中国现代神经疾病杂志》2022年第11期993-999,共7页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家自然科学基金资助项目(项目编号:81672506);国家自然科学基金资助项目(项目编号:81872052)。

摘　　要：目的探讨脑膜瘤术后复发相关影响因素。方法选择2010年5月至2011年1月在首都医科大学附属北京天坛医院行显微外科手术切除的176例脑膜瘤患者,回顾总结其临床资料、影像学资料、肿瘤切除程度和术后病理分级分型。Kaplan-Meier生存曲线和Log-rank检验筛查术后复发相关影响因素,多因素Cox比例风险回归模型行生存分析。结果术前Karnofsky功能状态评分(KPS)<70分者中位无进展生存期(PFS)短于KPS评分≥70分者[(8.04±1.98)年对(8.08±1.18)年;χ^(2)=5.370,P=0.020],瘤周水肿2~3级者中位PFS短于瘤周水肿0~1级者[(8.05±1.79)年对(8.06±1.09)年;χ^(2)=9.805,P=0.002],硬脑膜侵袭者中位PFS短于硬脑膜未侵袭者[(7.97±1.70)年对(8.06±1.09)年;χ^(2)=12.357,P=0.000],WHO 2~3级者中位PFS短于WHO 1级者[(5.14±2.07)年对(8.12±0.87)年;χ^(2)=113.774,P=0.000]。多因素Cox比例风险回归模型分析显示,WHO 2~3级可增加脑膜瘤术后复发风险(RR=15.693,95%CI:5.905~41.707;P=0.000)。结论术前KPS评分、瘤周水肿、硬脑膜侵袭和WHO分级可能影响脑膜瘤术后复发,其中WHO 2~3级增加脑膜瘤术后复发风险。Objective To investigate the influencing factors of postoperative meningioma recurrence.MethodsA total of 176 patients with meningioma treated in Beijing Tiantan Hospital,Capital Medical University from May 2010 to January 2011 were included.The general information,imaging findings,extent of tumor resection and postoperative pathological results were analyzed.Kaplan-Meier survival curve comparison and Log-rank test were used to compare the related influencing factors of meningioma recurrence.Multifactor Cox’s proportional hazards regression model was used for survival analysis.ResultsThe median progression free survival(PFS)of patients with preoperative Karnofsky P2erformance Status(KPS)<70 was lower than that with KPS≥70[(8.04±1.98)years vs.(8.08±1.18)years;χ=5.370,P=0.020].The median PFS of patients with peritumoral edema grade 2-3 was lower than that with peritumoral edema grade 0-1[(8.05±1.79)years vs.(8.06±1.09)years;χ~2=9.805,P=0.002].The median PFS of patients with dural mater invasion was lower than that without dural mater invasion[(7.97±1.70)years vs.(8.06±1.09)years;χ~2=12.357,P=0.000].The median PFS of patients with WHO grade 2-3 was lower than that with WHO grade 1[(5.14±2.07)years vs.(8.12±0.87)years;χ~2=113.774,P=0.000].Multivariate Cox’s proportional hazards regression model showed that WHO grade 2-3 could iCnocrnecalsues itohnes risk of postoperative meningioma recurrence(RR=15.693,95%CI:5.905-41.707;P=0.000).The preoperative KPS score,peritumoral edema,dura mater invasion and WHO grade may affect the recurrence of meningioma,and WHO grade 2-3 can increase the risk of meningioma recurrence.

关 键 词：脑膜瘤 显微外科手术 复发 比例危险度模型 无进展生存期 

分 类 号：R739.45[医药卫生—肿瘤]