成人幕上低级别胶质瘤(WHOⅡ级)患者术后生活质量相关因素评估

Assessment for Relevant Factors of Quality of Life in Adults with Surgically Managed Cerebral Supratentorial Low Grade Glioma(WHO Grade Ⅱ)

目的探讨成人幕上低级别胶质瘤(WHOⅡ级)患者术后生活质量的影响因素。方法回顾性分析2008年10月—2010年5月经手术切除病变、术后病理证实为低级别胶质瘤的115例患者临床资料,术后随访6～24个月。以患者年龄、性别、主要临床症状、病变部位、病变大小及病理结果为自变量,以术后Karnofsky评分(KPS)改善为因变量,采用Logistic回归分析研究相关影响因素。采用秩和检验比较不同组间KPS差异。结果随访至术后6个月,患者年龄、病变大小、病变部位、切除范围以及是否有癫痫史在KPS比较中,其结果有统计学意义(P<0.05)。随访至术后12个月,切除范围和癫痫史对KPS评分已无影响(P>0.05)。病理类型、术前是否存在神经功能障碍与术后KPS改善在单因素和多因素比较中无统计学意义。结论患者年龄≤50岁、术前有癫痫史、肿瘤直径≤4cm、病变表浅、肿瘤全切除的患者术后KPS改善好于年龄>50岁、术前无癫痫史、肿瘤直径>4cm、病变深在、肿瘤次全切除的患者。患者术前是否存在神经功能障碍和病理类型与术后生活质量是否改善无明显关系。复发也是影响患者术后KPS改善的因素。

Objective To assess the quality of life in adults with surgically managed cerebral supratentorial low grade glioma（WHO grade Ⅱ） and the relevant factors.Methods We retrospectively analyzed the clinical data of 115 patients with histologically proven supratentorial low grade glioma enrolled at West China Hosptial from October 2008 to May 2010.Follow-up lasted for 6 to 24 months after operation.Logisitc regression analysis is used to test the relevant factors with age,gender,main clinical manifestations,lesion location,lesion size and pathological results as the independent variables,and Kamofsky postoperative scale（KPS） scores as dependent variable.KPS scores of different groups were analyzed using the rank test.Results After 6 months of follow-up,we found that age,size,location,extent of surgical excision and eplispy history showed a statistical significance in KPS comparison（P0.05）.Till the 12th month in the follow-up,the extent of surgical excision and eplispy history were not statistically significant any more（P0.05）.Histology type and neurological deficit had no relationship with KPS improvement in both single factor analysis and multivariate analysis.Conclusions Patients with an age older than 50 years,preoperative epilepsy history,the largest diameter of the tumor less than 4 cm,shallow lesions,and complete tumor resection have a better KPS improvement after operation than those with corresponding opposite conditions.There is no obvious relationship between histology type,neurologic deficits and KPS improvement after operation.Recurrence is also a factor influencing KPS improvement after operation.