幕下弥漫性胶质瘤患者预后相关因素分析

Analysis of prognostic factors in patients with subtentorial diffuse glioma

目的:探究幕下弥漫性胶质瘤预后的影响因素。方法:收集2016年1月—2020年6月天津市环湖医院经手术治疗的35例幕下胶质瘤患者的临床资料,分析年龄、性别、肿瘤切除程度、α地中海贫血伴智力低下综合征X染色体相关蛋白(ATRX)基因突变、O6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)启动子区甲基化对幕下弥漫性胶质瘤患者的总生存期(OS)及无进展生存期(PFS)的影响。结果:幕下弥漫性胶质瘤平均PFS为13.28个月(95%CI:10.14~16.42),平均OS为15.97个月(95%CI:12.43~19.52);肿瘤全切或次全切、术后卡氏功能状态评分标准(KPS评分)≥70分、MGMT甲基化及ATRX突变是PFS预后良好的因素;肿瘤全切或次全切、术后KPS评分≥70分、年龄<48岁及ATRX突变是OS预后良好的因素。结论:年龄小、肿瘤切除范围大、术后KPS评分≥70分、ATRX突变的幕下弥漫性胶质瘤患者术后有更长的生存期。

Objective:To investigate the prognostic factors of subtentorial diffuse glioma.Methods:Clinical data of 35 patients with subatentorial glioma treated by surgery in Tianjin Huanhu Hospital from January 2016 to June 2020 were collected to analyze the effects of age,gender,degree of tumor resection,alpha thalassemia retardation syndrome X-linked(ATRX)gene mutation and O6-methylguanine-DNA methyltransferase(MGMT)promoter methylation on overall survival(OS)and progression-free survival(PFS)of patients with subatentorial diffuse glioma.Results:The mean PFS and OS of subatentorial diffuse glioma were 13.28 months(95%CI:10.14-16.42)and 15.97 months(95%CI:12.43-19.52).Total or subtotal tumor resection,postoperative KPS score≥70,MGMT methylation and ATRX mutation were the factors contributing to a good prognoses of PFS.Total or subtotal resection of tumor,postoperative KPS score≥70,age<48 years and ATRX mutation were the prognoses of good OS.Conclusion:Patients with subtentorial diffuse glioma with young age,large tumor resection range,postoperative KPS score≥70 and ATRX mutation have a longer postoperative survival period.