额颞叶胶质瘤相关性癫痫发生率及预后分析  

Incidence and prognosis of frontotemporal lobe glioma-related epilepsy

作　　者：钟如智 向鑫 胡孟庆 王瑾 鲁玉梅 孙玉明[1] 刘方军[1] 石祥恩[2] 雷霆 Zhong Ruzhi;Xiang Xin;Hu Mengqing;Wang Jin;Lu Yumei;Sun Yuming;Liu Fangjun;Shi Xiang′en;Lei Ting(Department of Neurosurgery,Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China;Department of Neurosurgery,Fu Xing Hospital,Capital Medical University,Beijing 100038,China;the Department of Neurosurgery,Dongguan Kanghua Hospital,Dongguan 523000,China)

机构地区：[1]首都医科大学三博脑科医院神经外科,北京100093 [2]首都医科大学附属复兴医院神经外科,北京100038 [3]东莞康华医院神经外科,东莞523000

出　　处：《中国医师进修杂志》2023年第12期1063-1066,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析不同级别额颞叶胶质瘤相关性癫痫发生率及预后。方法回顾性分析2019—2021年首都医科大学三博脑科医院208例额颞叶胶质瘤患者的临床资料,按2016年世界卫生组织(WHO)中枢神经系统肿瘤分类标准,统计不同级别肿瘤患者的术前和术后癫痫发生率、改良Rankin量表(MRS)评分和Engel疗效分级评分。结果额颞叶胶质瘤患者中,男性多于女性,40~59岁年龄高发,术前WHOⅠ级和Ⅱ级胶质瘤相关性癫痫发生率分别为100.0%(33/33)和60.9%(14/23),而WHOⅣ级胶质瘤则为19.0%(19/100)。随访(22±9)个月,随访期WHOⅠ、Ⅱ和Ⅲ级胶质瘤相关性癫痫发生率显著下降;接受肿瘤全切和次全切的胶质瘤患者癫痫发生率比较差异无统计学意义(P>0.05)。肿瘤发生的侧别和基因表型与癫痫的发生无相关性(P>0.05)。不同级别胶质瘤之间的Engel疗效分级比较差异无统计学意义(P>0.05)。Engel疗效分级1级者预后显著优于其他级别者。结论胶质瘤相关性癫痫发病率与肿瘤级别呈负相关,年龄和性别均是癫痫发生的危险因素。低级别胶质瘤患者术后癫痫发生率较高级别者下降更为显著,且预后更好,而不同级别胶质瘤患者的Engel疗效评分则无差异。Objective To analyze the incidence and prognosis of epilepsy in frontotemporal lobe glioma.Methods The clinical data of 208 patients with frontotemporal lobe gliomas in Sanbo Brain Hospital Capital Medical University from 2019 to 2021 were analyzed retrospectively.According to the 2016 World Health Organization(WHO)classification of tumors of the central nervous system,the incidence of epilepsy,Modified Rankin Scale(MRS)score,and Engel Outcome Scale of patients with different grades of tumors were calculated.Results Among all the patients with frontotemporal lobe gliomas,there was more males than females,and it was more common in the 40-59 age group.The incidence of epilepsy associated with WHO grade Ⅰ and Ⅱ glioma was 100.0%(33/33)and 60.9%(14/23),respectively,while that of WHO grade Ⅳ glioma was 19.0%(19/100).The average follow-up time was(22±9)months.During the follow-up period,the incidence of WHO grade Ⅰ,Ⅱ and Ⅲ glioma-related epilepsy decreased significantly.There was no significant difference in the incidence of glioma-related epilepsy between the total and subtotal resection groups(P>0.05).There was no statistical correlation between the side of tumor occurrence and the occurrence of epilepsy(P>0.05),also between the gene phenotype and the occurrence of epilepsy(P>0.05).There was no significant difference in the Engel Outcome Scale among different grades of gliomas(P>0.05).The prognosis of patients with Engel Outcome Scale Class 1 was significantly better than that of other grades.Conclusions The incidence of glioma-related epilepsy is negatively correlated with tumor grade.Age and sex are risk factors for glioma-related epilepsy.The incidence of postoperative epilepsy in patients with low grade glioma is significantly lower than that in patients with high grade glioma,and the prognosis is better.However,there is no significant difference in the Engel Outcome Scale among different grades of gliomas.

关 键 词：额颞叶 胶质瘤 脑肿瘤分级 癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]