成人脑胶质母细胞瘤术前非影像学预后危险因素综合评估

Comprehensive assessment of preoperative non-imaging prognostic risk factors for adult glioblastoma

目的综合脑胶质母细胞瘤(GBM)术前非影像学危险因素评估预后。方法回顾性分析159例脑GBM病人术前非影像学因素对总生存期(OS)的影响,对性别、发病年龄、术前KPS评分、血小板与淋巴细胞比(PLR)、肿瘤部位、肿瘤最大直径等因素行Kaplan-Meier生存分析和Cox回归分析,并利用回归系数计算预后指数(PI),利用Cutoff Finder网页工具求PI界值划分高危、低危组,并对两组病人的OS进行统计学分析。结果术前KPS评分(RR=1.78)、PLR(RR=1.68)、年龄(RR=1.45)是影响GBM病人预后的独立危险因素(P<0.05)。PI界值为2.25,PI>2.25为高危组,PI≤2.25为低危组,两组OS差异有统计学意义(P<0.01)。结论 PI计算简单易于推广,对GBM病人具有较高的预后预测价值。

Objective To comprehensively evaluate the prognosis by preoperative non-imaging risk factors in patients with glioblastoma（GBM）. Methods The effect of preoperative non-imaging factors on overall survival（OS） in 159 GBM patients were analyzed retrospectively. Kaplan-Meier survival analysis and Cox regression analysis were used for the factors as sex, age of onset,preoperative KPS score, platelet to lymphocyte ratio（PLR）, tumor site, the maximum diameter of tumor and so on. Then, the regression cofficient was used to calculate the prognosis index（PI） and the Cutoff Finder web tool to calculate the PI boundary value, and the patients were divided into the high risk group and low risk group based on PI boundary value. Finally, patients＇ OS of the two groups was statistically analyzed. Results The preoperative KPS score（RR = 1.78）, PLR（RR = 1.68） and age（RR = 1.45） were independent risk factors influencing prognosis of GBM patients（P 0.05）. The PI boundary value was 2.25, then more than 2.25 served as high-risk group and less than or equal to 2.25 as low-risk group, and the difference of OS between the two groups was statistically significant（P 0.01）. Conclusion PI is simple to calculate and easy to be popularized, and has higher predictive value for GBM patients＇ prognosis.