高分级脑胶质瘤术后复发的相关影响因素分析

INFLUENCING FACTORS FOR POSTOPERATIVE RECURRENCE OF HIGH-GRADE GLIOMA

目的探讨影响高分级脑胶质瘤术后复发的相关因素,为临床对脑胶质瘤预后判断提供帮助。方法回顾性分析我院神经外科150例高分级脑胶质瘤病人的临床资料,采用SPSS软件分析各因素与肿瘤复发的关系。结果单因素分析结果显示,年龄(χ~2=21.74,P<0.05)、术前抽搐(χ~2=9.76,P<0.05)、肿瘤病理分级(χ~2=7.64,P<0.05)、术后放疗(χ~2=21.79,P<0.05)、术后化疗(χ~2=31.52,P<0.05)以及肿瘤分子标志物IDH1突变状态(χ~2=33.79,P<0.05)与高分级脑胶质瘤病人术后复发有关;多元Logistic逐步回归分析结果显示,年龄(OR=4.29,95%CI=2.05~8.97,P<0.05)、术后放疗(OR=2.81,95%CI=1.24~6.37,P<0.05)、术后化疗(OR=7.69,95%CI=3.04~19.44,P<0.05)、IDH1突变状态(OR=5.51,95%CI=2.64~11.49,P<0.05)是高分级脑胶质瘤病人术后复发的独立影响因素。结论年龄>50岁、术后未行放化疗、IDH1野生型是高分级脑胶质瘤病人术后复发的危险因素。

Objective To investigate the influencing factors for postoperative recurrence of high-grade glioma,and to provide some help for prognostic evaluation of glioma. Methods A retrospective analysis was performed for the clinical data of150 patients with high-grade glioma who were treated in Department of Neurosurgery in our hospital.SPSS software was used to analyze the association between various factors and tumor recurrence. Results The univariate analysis showed that age（χ~2=21.74,P0.05）,preoperative convulsion（χ~2=9.76,P0.05）,tumor grade（χ~2=7.64,P0.05）,postoperative radiotherapy（χ~2=21.79,P0.05）,postoperative chemotherapy（χ~2=31.52,P0.05）,and IDH1 mutation status（χ~2=33.79,P0.05）were associated with postoperative recurrence of high-grade glioma.The results of the multivariate logistic stepwise regression analysis showed that age（odds ratio（OR）=4.29,95% confidence interval（CI）=2.05-8.97,P0.05）,postoperative radiotherapy（OR=2.81,95%CI=1.24-6.37,P 0.05）,postoperative chemotherapy（OR=7.69,95%CI=3.04-19.44,P 0.05）,and IDH1 mutation status（OR=5.51,95%CI=2.64-11.49,P0.05）were independent influencing factors for postoperative recurrence in patients with high-grade glioma. Conclusion Age50 years,absence of radiochemotherapy after surgery,and wildtype IDH1 are risk factors for postoperative recurrence in patients with high-grade glioma.