幕上Ⅱ级胶质瘤发展与预后的多因素分析

Related factors influencing the progression and prognosis of supratentorial grade II gliomas （a report of 65 cases）

目的探讨影响幕上WHOⅡ级胶质瘤发展与患者早期预后的相关因素。方法收集自2005年1月至2010年6月在厦门大学附属中山医院神经外科手术治疗的65例幕上Ⅱ级胶质瘤患者的临床资料，术后随访10～84个月。生存分析采用Kaplan—Meier法，差异的显著性检验应用log-rank法，对单因素分析中差异有统计学意义者进行COX回归比例风险模型分析。结果单因素分析结果显示影响患者无进展生存时间的因素包括：发病年龄、首发症状、术前卡氏功能状态评分（KPS评分）、肿瘤生长形态、肿瘤是否强化、手术切除程度及肿瘤病理类型（均P〈0．05）；回归分析示年龄、肿瘤是否强化及手术切除程度与患者无进展生存期密切相关。结论幕上Ⅱ级胶质瘤患者的无进展生存时间与多种因素有关，年龄、肿瘤是否强化及手术切除程度是影响患者早期预后的独立危险因素。

Objective To investigate the related factors affecting the progression and early prognosis of patients with supratentorial WHO grade II gliomas. Methods Clinical data of 65 patients with supratentorial grade II gliomas, treated in our hospital from January 2005 to June 2010, were collected and analyzed. Follow-up was performed for 10-84 months. Univariate analysis was estimated by using Kaplan-Meier method; the differences between groups were analyzed by a log-rank test. The factors （P〈0.05 in univariate analysis） were analyzed by COX proportional hazards regression model in the multivariate analysis. Results Univariate analysis demonstrated that age of onset, initialpresentation, Karnofsky （KPS） scale scores at admission, tumor growth style, tumor enhancement pattern, extent of surgical resection and pathological subtype were associated with progression-free survival time （P〈0.05）. Multivariate analysis showed that age, tumor enhancement pattern and extent of resection were significantly associated with progression-free survival time （P〈0.05）. Conclusion The progression-free survival time of patients with supratentorial grade II gliomas is associated with many factors; age, tumor enhancement pattern and extent of surgical resection were independent risk factors for patients＇ early prognosis.