星形细胞肿瘤的预后因素分析

Prognostic factors of astrocytic tumors

目的探讨影响星形细胞肿瘤预后因素,为临床治疗提供理论依据。方法复习167例星形细胞肿瘤患者的资料,使用Kaplan-Meier单因素生存分析法及多因素Cox比例风险模型进行分析。结果单因素分析结果显示性别、年龄、术前癫痫、组织学分级、术前高级神经功能状态、术后患者机能状况评分等因素与患者预后有显著相关性(P<0.01);肿瘤切除程度、术后高级神经功能状态、综合治疗情况与预后有相关性(P<0.05)。高级别星形细胞肿瘤病例COX多因素分析则显示性别、术后KPS评分、术后个体化综合治疗情况与患者预后显著相关(P<0.01)。结论患者性别、年龄、病理组织学分级、术前癫痫、高级神经功能状态对预后影响较大,多因素分析显示综合治疗与高级别星形细胞肿瘤患者预后显著相关。

Objective To explore the prognostic factors of astrocytic tumors with an aim of providing theoretical basis for clinical therapy.Methods The data of 167 patients with astrocytic tumors treated in Cancer Center of Sun Yat-sen University or the Second Clinical Medicine College of Jinan University were reviewed and analyzed with Kaplan-Meier single factor analysis for patient survival and multi-factor analysis of Cox proportion risk model.Results The single factor analysis results demonstrated that the patient＇s sex,age,preoperative epilepsy,histological grades,preoperative high leave nervous system function,and postoperative Karnofaky performance status/KPS score were significantly related to the prognosis of the patients（P〈0.01）.The extent of surgical resection,postoperative high nervous system function and multimodality treatment also correlated with the the prognosis of the patients（P〈0.05）.Furthermore,multi-factor analysis results in high grade gliomas showed that the patient＇s sex,postoperative KPS score and multimodality treatment were all the independent prognostic factors.Conclusion The single factor analysis suggests that patient＇s sex,age,histological grades and preoperative epilepsy,high leave nervous system function may affect the prognosis of the patients while multi-factor analysis shows multimodality is significantly beneficial to the prognosis of high grade astrocytic tumors.