原发性人脑胶质瘤的预后影响因素:基于SEER数据库的分析

Risk factors for prognosis of patients with primary brain glioma:an analysis based on the SEER database

目的探讨原发性人脑胶质瘤病人预后影响因素。方法通过SEER*Stat(8.3.8版本)软件搜集SEER数据库2004~2015年原发性人脑胶质瘤病人的临床资料,采用R(4.0.2版本)软件进行单因素与多因素Cox回归分析,通过Kaplan-Meier生存曲线分析不同治疗方式和婚姻状态与病人预后的关系。结果共纳入符合标准的原发性人脑胶质瘤18523例。多因素Cox回归分析结果显示,年龄≥30岁、肿瘤直径≥2 cm、病理级别高、肿瘤位于额叶以外部位、离婚、丧偶为原发性胶质瘤预后不良的独立危险因素(P<0.05),手术治疗、术后放疗、化疗是原发性胶质瘤预后的独立保护因素(P<0.05)。生存曲线分析结果显示,手术治疗(全切除或部分切除肿瘤)、术后放疗、化疗均明显延长原发性胶质瘤病人的生存期(P<0.05),婚姻状态为结婚的病人预后明显好于丧偶的病人(P<0.05)。结论对原发性人脑胶质瘤,尽可能手术全切除肿瘤,同时术后辅助放化疗,能够延长病人的生存时间。同时,临床应加强病人心理干预。

Objective To explore the risk factors for the prognosis of patients with primary brain glioma.Methods SEER*Stat(version 8.3.8)software was used to search the clinical data of patients with primary brain glioma who were registered in the SEER database from 2004 to 2015.The R(version 4.0.2)software was used to analyze the risk factors by univariate and multivariate Cox regression analysis,and to analyze the relationship between different treatment methods and marital status and patient prognosis by Kaplan-Meier survival curve analysis.Results A total of 18523 patients with primary brain glioma that met the criteria were included.Multivariate Cox regression analysis showed that age≥30 years,tumor diameter≥2 cm,high pathological grade,tumor located outside the frontal lobe,divorce and widowhood were independent risk factors for the poor prognosis of primary glioma patients(P<0.05),and surgery,postoperative radiotherapy and chemotherapy were independent protective factors for the prognosis of glioma patients(P<0.05).Survival curve analysis showed that surgical treatment(total or partial tumor resection),postoperative radiotherapy,and chemotherapy significantly prolonged the survival time of glioma patients(P<0.05),and the prognosis of married patients was significantly better than that of widowed patients(P<0.05).Conclusions For primary brain glioma,surgical removal of the tumor as much as possible,and adjuvant radiotherapy and chemotherapy after the operation can prolong the survival time of the patient.At the same time,clinical psychological intervention of glioma patients should be strengthened.