临床神经外科杂志2019，Vol.16Issue(5)：430-433,438,5.DOI:10.3969／j.issn.1672-7770.2019.05.013
高级别胶质瘤的预后影响因素分析
Analysis of factors related to prognosis in patients with high-grade glioma
摘要
Abstract
Objective To investigate the factors affecting the prognosis of patients with high-grade glioma.Methods The data of 384 cases of high-grade gliomas surgically removed in the Department of Neurosurgery , the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2015 were analyzed retrospectively to exclude non-surgical deaths.The survival analysis was performed by using Kaplan-Meierand the Cox proportional hazard regression model was used for prognostic multivariate analysis.Results There were 384 high-grade gliomas in this group, including 164 cases of WHO Ⅲ grade and 220 cases of WHO Ⅳ grade.All of them received surgery from the same group of doctors.Postoperative radiotherapy and chemotherapy were performed in 212 patients and 243 patients.At 1 and 3 years follow-up, the overall survival rates were 73.7%and 17.1%, respectively.The WHOⅢgrade 1 and 3 year survival rates were 92.3%and 29.5%, respectively.The WHO Ⅳ grade 1 and 3 years survival rates were 60.2% and 11.7%, respectively.Multivariate analysis showed that postoperative adjuvant radiotherapy and chemotherapy significantly improved the survival rate of high-grade glioma ( P ＜0.05 ).Cox proportional hazard regression model analysis showed age ＞60 years ( RR ＝1.701, P ＝0.016), preoperative KPS score ＜70 points (RR＝2.231,P＜0.001), WHO Ⅳ grade( RR＝2.181,P＜0.001 ) tumors were not completely resected ( RR ＝2.101, P ＜0.001 ), and no postoperative radiochemotherapy(RR＝1.562,P＝0.007) was an independent risk factor for the overall survival of high-grade gliomas.There was no significant difference in gender , tumor size, necrosis／capsule change, and total stage(all P＞0.05).Patients with age ＜60 years, preoperative KPS score ≥70, WHO Ⅲ grade glioma , total tumor resection , and postoperative combined chemoradiotherapy had longer overall survival(OS).Conclusion The age of onset ＜60 years old, KPS score≥70, low WHO grade (Ⅲ), total tumor resection, postoperative radiotherapy and chemotherapy of glioma patients with good prognosis , combined with radiotherapy and chemotherapy can improve the efficacy of glioma.关键词
高级别胶质瘤/预后/影响因素Key words
high-grade glioma/ prognosis/ factor analysis分类
医药卫生引用本文复制引用
朱国华,麦麦提力·米吉提,李彦东,王昀,更·党木仁加甫..高级别胶质瘤的预后影响因素分析[J].临床神经外科杂志,2019,16(5):430-433,438,5.基金项目
新疆维吾尔自治区自然科学基金(2018D01A53) （2018D01A53）
