幕上低级别星形细胞瘤生存分析

Supratentorial low grade astrocytomas survival analysis

目的：分析影响幕上低极别星形细胞瘤（ＬＧＡ）患者生存的因素。材料和方法：对７５例经ＣＴ诊断的幕上低级别星形细胞瘤进行了单及多因素生存分析。结果：多因素分析显示年龄大于４０岁，术前无癫痫，肿瘤大于５ｃｍ，肿瘤位于丘脑或脑室，手术部分切除或活检以及病理Ｋｅｒｎｏｈａｎ分级Ⅱ级为六个影响生存的最危险因素。单因素分析结果显示年龄小于４０岁，术前有癫痫，肿瘤小于５ｃｍ，病理分级Ⅰ级以及手术全切与生存延长有明显关系。放射治疗在单因素及多因素分析中均显示对生存无明显影响。结论：手术方法、肿瘤病理分级、部位、大小及患者年龄等是决定该类肿瘤患者生存的重要因素。

Objective: To evaluate the factors that affect the survival of the supratentorial low grade astrocytomas patients. Methods:75 cases with superatentorial low grade astrocytomas for their survival factors were evaluated with simple and multivariate analysis to determine the important one in predicting length of survival. All cases were diagnosed by CT scan. Results: With simple analysis, five factors showed highly significant to long survival: age<40 years 。(P<0 001), preoperative seizures (P<0 001),tumor <5cm (P=0 0001), Kernohan grade Ⅰ (P<0 01) and total removal (P<0 01). With multivariate analysis, six factors showed significant dangerous to survival: age>40 (P<0 01), no preoperative seizures (P<0 01), tumor >5cm (P=0 0001), tumor located at thalamus or ventricles (P<0 05), partial removal or biopsy only (P<0 01) and Kernohan Ⅱ degree (P<0 01). Postoperative radiotherapy appeared to be of no benefit to survival. Conclusion: The procedure of treatment, the degree, size, and site of the tumor, and the age of the patients are the main factors that affects the survival rate of this kind of patient.