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目的:探讨初发胶质母细胞瘤扩大切除与患者预后的关系。方法:前瞻性纳入河南省人民医院(郑州大学人民医院，河南大学医学院)神经外科自2014年1月至2017年1月接受手术治疗的初发胶质母细胞瘤患者，根据患者术前1周内、术后24 h内MRI T1增强序列及液体衰减反转恢复序列(FLAIR)影像获得术前强化肿瘤体积、强化肿瘤残余体积和FLAIR序列的肿瘤体积、FLAIR序列的肿瘤残余体积，计算肿瘤切除程度。采用Cox比例风险回归模型确定胶质母细胞瘤患者总生存期(OS)的影响因素，采用Kaplan-Meier法绘制患者的生存曲线及Log-rank检验比较强化肿瘤全切除组和未全切除组、FLAIR序列的肿瘤全切除组和未全切除组患者的生存率。结果:最终纳入患者128例，强化肿瘤全切71例(55.5%)，其中FLAIR序列的肿瘤全切17例(13.3%)。Cox比例风险回归分析结果显示术前Karnofsky功能状态评分(KPS)、O6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)启动子甲基化状态、强化肿瘤残余体积、FLAIR序列的肿瘤残余体积、FLAIR序列的肿瘤切除程度是患者OS的独立影响因素(n P<0.05)。强化肿瘤全切除组患者的生存率明显高于强化肿瘤未全切除组，差异有统计学意义(n P<0.05)。强化肿瘤全切除患者中，FLAIR序列的肿瘤全切除组患者的生存率明显高于FLAIR序列的肿瘤未全切除组，差异有统计学意义(n P<0.05)。n 结论:MRI FLAIR序列显示的肿瘤残余是影响OS的一个重要因素，初发胶质母细胞瘤的扩大切除是必要的。“,”Objective:To explore the relation between extended resection and prognosis of primary glioblastoma.Methods:A prospective study was performed. The subjects were from the colony of patients with primary glioblastoma who underwent surgical resection in our hospital from January 2014 from January 2017. Tumor volume and tumor residual volume showed by MR imaging T1 enhanced sequences (Group A and Group B), and tumor volume and tumor residual volume showed by fluid-attenuated inversion recovery (FLAIR) sequences (Group A1 and Group A2) were obtained within one week before surgery and 24 h after surgery, respectively; and the degrees of tumor resection were calculated. Cox proportional hazards regression model was used to determine factors influencing overall survival (OS) in glioblastoma patients. Kaplan-Meier method was used to plot the survival curves of these patients. Log-rank test was used to compare the survival rates of patients from Group A and Group B, and patients from Group A1 and Group A2.Results:A total of 128 patients were included; 71(55.5%) were into Group A, and 17 (13.3%) were into Group A1. Multivariate analysis showed that preoperative Karnofsky performance scale (KPS) scores, promoter methylation status of O-6-methylguanine-DNA methyltransferase (MGMT), tumor residual volume by T1 enhanced sequences, tumor residual volume by FLAIR sequences, and tumor resection degree by FLAIR sequences were independent influencing factors for OS (n P<0.05). Survival rate of patients from Group A was significantly higher than that in Group B(n P<0.05); and survival rate of patients from Group A1 was significantly higher than that in Group A2 (n P<0.05).n Conclusion:Residual of primary glioblastoma showed by FLAIR sequences is an important factor affecting the prognoses, and extended resection is necessary.