作　　者： (张善娟）;

机构地区： 276800,山东省日照市人民医院放射科

出　　处： 《中国医师进修杂志》

摘　　要： 目的 探讨室管膜下区以及肿瘤中心距侧脑室壁边缘(TV)的最短距离与胶质母细胞瘤的预后关系.方法 回顾性分析2006—2016年130例胶质母细胞瘤的数据资料,其中45例肿瘤累及室管膜下区.采用卡方检验和生存分析进行统计分析.结果 卡方检验表明年龄、性别、肿瘤方位、肿瘤体积、术前癫痫、肿瘤切除程度在是否累及室管膜下区这两组中的分布差异无统计学意义(P>0.05),同样,年龄、性别、肿瘤方位、肿瘤体积、术前癫痫、肿瘤切除程度在TV<30 mm和TV≥30 mm这两个组间的分布也差异无统计学意义(P>0.05).单因素分析表明辅助性治疗(HR=0.765,95%CI:0.557~0.998,P=0.045)、室管膜下区(HR=2.996,95%CI:1.995~4.500,P<0.01)和手术切除程度(HR=0.472,95%CI:0.313~0.713,P<0.01)是生存时间的预测因素,将上述具有明显统计学意义的因素纳入多因素分析,结果表明切除程度(HR=0.563,95%CI:0.366~0.867,P=0.009)、辅助性治疗(HR=0.726,95%CI:0.529~0.997,P=0.048)、室管膜下区(HR=2.634,95%CI:1.725~4.022,P<0.01)都与胶质母细胞瘤患者的生存期相关.而在肿瘤累及室管膜下区的患者中,单因素分析表明辅助性治疗(HR=0.535,95%CI:0.332~0.863,P<0.01)和TV(HR=3.297,95%CI:1.738~6.253,P<0.01)都是可预测胶质母细胞瘤患者预后的预后因子,当将上述两个因素纳入多因素分析时,结果表明辅助性治疗(HR=0.540,95%CI:0.333~0.875,P=0.012)以及TV<30 mm(HR=3.234,95%CI:1.711~6.112,P<0.01)仍然与胶质母细胞瘤的预后有关.结论 肿瘤累及室管膜下区以及TV<30 mm是胶质母细胞瘤的预后危险因素. Objective To evaluate the relationship between subventricular zone(SVZ), the shortest distance from tumor centroid to the edge of the lateral ventricles (TV) and prognosis of patients with glioblastoma multiforme (GBM). Methods The clinical data of 130 patients with GBM in our hospital since 2006 to 2016 were retrospectively reviewed and 45 persons of these patients with SVZ were involved. Chi-square test and survival analysis was performed to identify prognostic factors associated with GBM. Results Chi-square test indicated that there were no significant differences in the distribution of age, gender, tumor location, tumor volume, preoperative epilepsy and the extent of resection in these two groups with involvement of SVZ or not (P>0.05). Similarly, there were no statistically significant differences in the distribution of age and sex, tumor location, tumor size, preoperative epilepsy between TV<30 mm and TV≥30 mm (P>0.05). Univariate analysis showed that adjuvant therapy (HR=0.765, 95%CI:0.557-0.998, P=0.045), SVZ (HR=2.996, 95%CI:1.995-4.500, P<0.01), and extents of resection (HR=0.472, 95%CI:0.313-0.713, P<0.01) were predictors of overall survival of patients with GBM, while the gender, age, tumor size, and preoperative epilepsy did not reach statistic significance (all P>0.05). When the parameters with statistical significance identified by univariate analysis were included in the multivariate analysis, the results showed that adjuvant therapy (HR=0.540, 95%CI:0.333-0.875, P=0.012), SVZ (HR=2.634, 95%CI:1.725-4.022, P<0.01) and extents of resection (HR = 0.563, 95% CI: 0.366- 0.867, P = 0.009) were independent prognostic indicators in patients with GBM. Univariate analysis showed that adjuvant therapy (HR = 0.535, 95% CI: 0.332- 0.863, P<0.01) and TV (HR = 3.297, 95% CI: 1.738- 6.253, P<0.01) were predictors of overall survival of patients of GBM with SVZ involvement, while the gender, age, tumor size, and preoperative epilepsy not reached statistic significance (all P>0.05). When the parameters with statistical significance identified by univariate analysis were included in the multivariate analysis, the results showed that adjuvant therapy (HR=0.726, 95%CI:0.529-0.997, P=0.048) and TV(HR = 3.234, 95%CI: 1.711- 6.112, P<0.01) was independent prognostic indicator in patients of GBM with SVZ involvement (P<0.05). Conclusions Involvements of SVZ and TV less than 30 mm are the risk factors for the prognosis of patients with GBM.

分 类 号： [Z1]