老年弥漫性胶质瘤患者临床影像特征及其预后意义  

Clinical and radiological characteristics and prognostic significance of elderly patients with diffuse glioma

作　　者：刘桠菲 张庆浩 毛冲冲[1] 刘献志[1] Liu Yafei;Zhang Qinghao;Mao Chongchong;Liu Xianzhi(Department of Neurosurgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院神经外科,郑州450000

出　　处：《中华实验外科杂志》2025年第1期122-125,共4页Chinese Journal of Experimental Surgery

摘　　要：目的系统研究老年和年轻胶质瘤患者影像学指标的差异及其对预后的影响。方法本研究共纳入596例被诊断为世界卫生组织(WHO)2~4级弥漫性胶质瘤的患者,收集他们的临床、分子病理和影像学资料。使用ITK-SNAP 3.4.0对MRI成像特征进行定量分析。单因素和多因素分析用于评估预后因素。结果老年组和年轻组在WHO级别(P<0.01)、细胞核增殖抗原(Ki-67)指数(P<0.01)、异柠檬酸脱氢酶(IDH)突变(P<0.01)和1p/19q共缺失(P<001)方面差异有统计学意义。WHO级别(P<0.01)和IDH突变状态(P<0.01)是预后的独立预测因素。此外,在较低级别老年胶质瘤患者中,肿瘤实体有明显对比增强提示预后不良。结论老年胶质瘤患者在WHO级别、Ki-67指数、IDH突变和1p/19q共缺失等临床病理特征上与年轻患者不同,在影像学方面,肿瘤实体部分的明显对比增强是老年低级别胶质瘤预后不良的影像学特征之一。Objective To systematically study the differences in radiological indicators between elderly and young glioma patients and their impact on prognosis.Methods This study enrolled a total of 596 patients diagnosed with world health organization(WHO)grade 2-4 diffuse gliomas,and collected their clinical,molecular pathological,and radiological data.ITK-SNAP 3.4.0 was used for quantitative analysis of MRI imaging features.Univariate and multivariate analyses were used to evaluate the prognostic factors.Results There were statistically significant differences between the elderly and young groups in terms of WHO grade(P<0.01),proliferation cell nuclear antigen(Ki-67)index(P<0.01),isocitrate dehydrogenase(IDH)mutation(P<0.01),and 1p/19q codeletion(P<0.01).WHO grade(P<0.01)and IDH mutation(P<0.01)were independent predictors of prognosis.In addition,in elderly patients with lower-grade glioma,a tumor with obvious contrast enhancement in the solid parts indicated a poor prognosis.Conclusion Elderly glioma patients differ from young patients in clinical and pathological features such as WHO grade,Ki-67 index,IDH mutation,and 1p/19q codeletion.In terms of imaging,obvious contrast enhancement of solid parts in the tumor is one of the radiological characteristic indicating the poor prognosis of lower-grade gliomas in the elderly.

关 键 词：老年胶质瘤 临床因素 分子病理 影像学特征 预后 

分 类 号：R739.41[医药卫生—肿瘤]