人脑星形细胞肿瘤预后因素  

Prognostic factors for patients with astrocytic tumors

作　　者：丁涟沭[1] 刘道坤[2] 邓传宗[2] 顾志凯[2] 沈剑虹[2] 

机构地区：[1]南京医科大学附属淮安第一医院,南京淮安223000 [2]南通医学院附属医院,南京南通226001

出　　处：《现代医药卫生》2003年第10期1228-1230,共3页Journal of Modern Medicine & Health

摘　　要：目的 :研究影响人脑星形细胞肿瘤预后的因素 ,为临床治疗提供理论依据。方法 :经神经外科手术治疗的原发性星形细胞肿瘤病人89例。包括 :病人的年龄、性别、术前有无癫痫、术前机能状况 (KPS评分 )、手术时间、手术治疗方式、肿瘤的部位和范围、术后放疗 ,最后一次随访时的状况 (死亡或存活)以及死因。生存分析单因素使用Kaplan-Meier法计算生存率并采用logrank(对数秩 )检验。多因素分析使用COX比例风险模型 ,采用逐步回归分析。结果 :单因素分析显示年龄、术前KPS评分、术前癫痫、组织学分级、术后放疗等因素与患者预后有关(logrankP<0 01)多因素分析示患者的年龄、术前KPS评分、组织学分级均为独立的预后因素 ,而术前癫痫、术后放疗则未显示出与预后有关。性别、肿瘤部位、肿瘤范围、手术治疗方式等因素单因素、多因素分析均未发现与预后有关。结论 :患者部位、术前机能状况(KPS评分)、组织学分级对预后影响较大。而术前癫痫史、术后放疗对评判预后价值有限。患者的性别、肿瘤部位和范围、手术治疗方式可能与预后无关。Objective:To explore the prognostic factors for patients with astrocytic tumors.Methods:Data of89patients with astrocytic tuˉmors were collected enrolled in Nantong Medical College affiliated hospital from1994to1996.Relevant information included patient age,gender,preoperative KPS score,epilepsy before surgery,histologic grade,tumor location,tumor extension,extent of surgery,radiation,date of operation,date of death,status at the time of last communication(dead or alive),and cause of death.For the univariate analysis,survival probabilities were estiˉmated based on Kaplan-Meier's Product-Limit Survival Estimates method and logrank test was used to assess the association between patient survival and each variable.Multivariate regression analysis using Cox's proportional-hazards model was used to ascertain a simultaneous effect of outcome-related variables on survival.Results:Univariate analysis showed that patient age,KPS score,epilepsy before surgery,histologic grade,and radiation were significant factors for survival.While Multivariate survival analysis showed that patient age,histologic grade,and KPS score were independent statistically significant prognostic factors for patients with astrocytic tumors,whereas epilepsy befor surgery and radiation did not meet the significance level for entry into the stepwise model.And gender,tumor location,tumor extension and extent of sugery had no association with patient survival on both univariate and multivariate analysis.Conclusion:patient age,histologic grade and KPS score are associated strongly with survival while epilepsy before surgery and radiation appear to be of limited on prognostic value.And there is no correlation between gender and prognosis and between extent of surgery and prognosis.Neither tumor location nor tumor extension is associated with survival.

关 键 词：脑星形细胞肿瘤 预后 单因素分析 多因素分析 治疗 

分 类 号：R739.41[医药卫生—肿瘤]