脑胶质瘤患者预后的影响因素分析

Analysis of Influencing Factors for Prognosis of Patients with Brain Glioma

目的:分析脑胶质瘤患者预后的影响因素。方法:选取2017年1月—2020年1月在麻城市人民医院行手术治疗的156例脑胶质瘤患者作为研究对象,随访3年,随访结束时生存患者纳入预后良好组(n=99),死亡患者纳入预后不良组(n=99)。比较两组临床资料,分析脑胶质瘤患者预后的影响因素。结果:两组性别、术前水肿、术前癫痫占比比较,差异无统计学意义(P>0.05);预后不良组年龄>40岁、最大肿瘤直径≥6 cm、肿瘤病理分级为Ⅲ~Ⅳ级、次全切术、E盒结合锌指蛋白2(ZEB2)阳性表达、CC趋化因子配体20(CCL20)阳性表达占比高于预后良好组,术前卡氏评分(KPS评分)>70分、术后放疗、术后化疗、替莫唑胺化疗≥4个疗程患者占比均低于预后良好组,差异有统计学意义(P<0.05)。年龄>40岁、最大肿瘤直径≥6 cm、肿瘤病理分级Ⅲ~Ⅳ级、ZEB2阳性表达、CCL20阳性表达是脑胶质瘤预后不良的独立危险因素(P<0.05),术前KPS评分>70分、术后放疗、术后化疗、替莫唑胺<4个疗程是脑胶质瘤预后的独立保护因素(P<0.05)。结论:脑胶质瘤患者预后较差,临床应针对脑胶质瘤患者预后的危险因素与保护因素采取针对性应对措施,改善患者预后。

Objective:To analyze the influencing factors for the prognosis of patients with brain glioma.Methods:A total of 156 patients with brain glioma who underwent surgical treatment at People's Hospital of Macheng City from January 2017 to January 2020 were selected as the study subjects.After 3-year follow-ups,the patients who survived at the end of the follow-up were included in good prognosis group(n=99)and the patients who died were included in poor prognosis group(n=99).The clinical data of the two groups were compared.The influencing factors for the prognosis of brain glioma patients were analyzed.Results:There were no significant differences in gender,preoperative edema and preoperative epilepsy proportions between the two groups(P>0.05).The proportions of age>40 years,maximum tumor diameter≥6 cm,tumor pathological grade of GradeⅢ-Ⅳ,subtotal resection,positive expression of zinc finger E-box binding homeobox 2(ZEB2)and positive expression of CC chemokine ligand 20(CCL20)in poor prognosis group were higher than those in good prognosis group,and the proportion of patients with preoperative Karnofsky Performance Status(KPS score)>70 points,postoperative radiotherapy,postoperative chemotherapy and temozolomide chemotherapy of≥4 cycles in poor prognosis group were lower than those in good prognosis group,and the difference was statistically significant(P<0.05).Age>40 years,maximum tumor diameter≥6 cm,tumor pathological grade of GradeⅢ-Ⅳ,positive expression of ZEB2 and positive expression of CCL20 were independent risk factors for poor prognosis of brain glioma(P<0.05).Preoperative KPS score>70 points,postoperative radiotherapy,postoperative chemotherapy and temozolomide chemotherapy of<4 cycles were independent protective factors for the prognosis of brain glioma(P<0.05).Conclusion:The prognosis of brain glioma patients is poor.In clinical practice,targeted countermeasures should be taken to improve the prognosis of glioma patients by focusing on the risk factors and protective factors of the prognosis.