摘要
目的探讨与大脑半球恶性胶质瘤生存预后相关的临床因素。方法选择中山大学附属第一医院神经外科自2004年1月至2009年12月收治的194例恶性胶质瘤患者，其中间变性星形细胞瘤120例，胶质母细胞瘤74例，随访其生存状况，Kaplan—Meier生存分析与Cox多元回归分析患者无进展生存时间与总生存时间的影响因素。结果间变性星形细胞瘤和胶质母细胞瘤患者的无进展生存时间分别为18、10个月，总生存时间分别为21、12个月；Kaplan．Meier生存分析法显示年轻、10S评分高、肿瘤无强化、术前有抽搐症状及间变性星形细胞瘤患者无进展生存时间及总生存时间均较长，差异有统计学意义（P〈0．05）；Cox多元回归分析显示患者年龄、KPS评分、有无抽搐、病理分级是无进展生存时间、总生存时间的影响因素，年轻、KPS评分较高、有抽搐症状、间变性星形细胞瘤患者无进展生存时间与总生存时间较长。结论年龄较小、高KPS评分、间变性星形细胞瘤及术前有抽搐症状被提示是恶性胶质瘤患者获得较长生存期的保护因素，而性别、肿瘤部位、大小和手术切除程度对预后无影响，肿瘤强化与预后的关系有待进一步研究证实。
Objective To investigate the clinical factors influencing survival prognosis in patients with supratentorial malignant glioma （MG）. Methods A total of 194 patients with MG, admitted to our hospital from January 2004 to December 2009, were chosen in our study; anaplastic astrocytoma （AA） was noted in 120 patients and glioblastoma multiforme （GB） was noted in 74 patients. Their survival status was followed-up. Survival related statistics were calculated using the Kaplan-Meier method, and differences between survival curves were analyzed by the log-rank test. The interaction of each prognostic factor and their effect on overall survival （OS） and progression-flee survival （PFS） were analyzed with the Cox proportional hazards model. Results The median PFS and OS in AA patients were 18 and 21 months, and those in GB patients were 10 and 12 months. When PFS and OS were used as endpoints, AA patients lived longer than GB ones, while patients ≤40 years old lived longer than those ≥40 years old; patients with Kamofsky performance status （KPS） scored 80-100 had longer survival than those with KPS scored 60-70; patients with preoperative seizure enjoyed the same situation as compared with those without preoperative seizure. Both univariate and multivariate Cox analyses confirmed that independent influencing factors were age, KPS scores, grade of pathology and appearance of preoperative seizure; patients with young age, high KPS scores, low grade of pathology and preoperative seizure had longer PFS and OS than those without. Conclusion Young age, high KPS scores, low grade of pathology and preoperative seizure are protective prognostic factors in patients with MG, while gender, tumor size, tumor location, and extent of resection have no prognostic significance; the prognostic significance of contrast - enhancing is uncertain.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2012年第8期784-787,共4页
Chinese Journal of Neuromedicine
基金
广东省自然科学基金（10151008901000245、S20110100037081
广东省科技计划基金（20118031800242）
