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背景与目的:影响人脑恶性胶质瘤预后的因素众多,本文通过总结我们的临床病例,分析影响人脑恶性胶质瘤预后的因素。方法:收集自2003年10月至2004年4月在南方医科大学附属南方医院神经外科手术治疗的67例恶性胶质瘤患者的资料。生存分析单因素使用Kaplan-Meier法计算生存率并采用对数秩(log-rank)检验;多因素分析使用Cox比例风险模型,采用逐步回归分析。结果:单因素分析结果显示术前癫痫、肿瘤分化程度、肿瘤范围、术中病理标示肿瘤向周边侵袭性生长程度、手术切除程度及术后个体化综合治疗等因素与患者预后有关(P<0.05);多因素分析示手术切除范围、术后个体化综合治疗、肿瘤侵袭性生长程度、肿瘤的分化程度则是影响无瘤生存的独立因素。年龄、性别、KPS评分、肿瘤体积等因素两种分析均未发现与预后有关。结论:手术切除范围、术后个体化综合治疗、肿瘤侵袭性生长程度、肿瘤的分化程度对预后影响较大;而术前癫痫、肿瘤范围对判断预后价值有限;患者的年龄、性别、KPS评分、肿瘤体积与预后无关。
BACKGROUND & OBJECTIVE: There are many factors affecting the prognosis of human malignant glioma. In this paper, we summarize our clinical cases and analyze the factors affecting the prognosis of human malignant glioma. METHODS: The data of 67 patients with malignant gliomas who underwent surgical treatment of neurosurgery at Nanfang Hospital Affiliated to Southern Medical University from October 2003 to April 2004 were collected. Survival Analysis Univariate survival was calculated using the Kaplan-Meier method and log-rank test was used; multivariate analysis was performed using Cox proportional hazards model and stepwise regression analysis. Results: The results of univariate analysis showed that the factors such as preoperative epilepsy, tumor differentiation, tumor range, intraoperative pathological tumor invasive growth, surgical resection degree and postoperative individualized comprehensive treatment were related to prognosis (P <0.05 ); Multivariate analysis showed that the scope of surgical resection, postoperative individualized comprehensive treatment, tumor invasive growth, the degree of tumor differentiation is an independent factor affecting disease-free survival. Age, gender, KPS score, tumor volume and other factors were not found in the two prognosis. Conclusion: The range of surgical resection, postoperative individualized comprehensive treatment, tumor invasive growth and tumor differentiation have a great effect on prognosis. Preoperative epilepsy and tumor range have limited value in judging prognosis. The patients’ age, gender, KPS score The tumor volume has nothing to do with the prognosis.