颅脑肿瘤患者的预后影响因素分析Analysis of prognostic factors and survival curve of patients with craniocerebral tumor
杨柳,王蒙,赵培超,丁大领,王俊宽,薛茗予,薛志玲
摘要(Abstract)：
目的对颅脑肿瘤患者进行生存曲线分析,探讨影响颅脑肿瘤患者预后的相关因素。方法回顾性分析郑州大学第一附属医院2012-04—2015-01治疗的140例颅脑肿瘤患者的临床资料,对患者进行电话、门诊、微信等方式随访,随访截止2020-01-01,获取患者的生存状态或死亡时间,主要观察终点是总生存期,应用Kaplan-Meier法计算生存率,通过Cox比例风险模型行多因素分析,探讨颅脑肿瘤患者预后的影响因素。结果随访结束时,1a生存率为87.78%,3a生存率为43.33%,5a生存率为29.29%,中位生存时间(MST)为34.6个月。结合患者性别、年龄、病理类型、治疗方式等临床特征分析发现,年龄、手术方式、术前KPS评分、病理分型、有无术后放疗、有无术后化疗、Ki-67水平对患者术后预后有显著影响(P<0.05);而性别、肿瘤最大直径、有无钙化、有无脑积水对生存期无明显影响(P>0.05);COX比例风险回归分析显示,年龄、手术方式、术前KPS、病理分型、术后放疗、术后化疗、Ki-67水平是颅脑肿瘤患者预后的影响因素。结论年龄越大、术前KPS评分越低、Ki-67表达水平越高、病理类型为脑转移瘤患者预后越差,全切手术、术后进行放化疗将有助于改善患者预后。
关键词(KeyWords)： 颅脑肿瘤;生存分析;预后;危险因素;Cox比例风险模型;Kaplan-Meier法
基金项目(Foundation): 河南省科技攻关项目（编号：172102310058）
作者(Author): 杨柳,王蒙,赵培超,丁大领,王俊宽,薛茗予,薛志玲
参考文献(References)：
- [1]WU J C.Risk factors of meningioma[J].J Chin Med Assoc,2014,77(9):451-452.DOI:10.1016/j.jcma.2014.07.005．
- [2]SYED S,KARAMBIZI D I,BAKER A,et al.Case Report:A Comparative Report on Intracranial Tumorto-Tumor Metastasis and Collision Tumors[J].World Neurosurg,2018,116(7):454-463.DOI:10.1016/j.wneu.2018.04.109．
- [3]CHICA J,YEPES I,BURKS S S,et al.Case of an intracranial malignant peripheral nerve sheath tumor in the setting of pacer-dependent heart block[J].Asian JNeurosurg,2018,13(1):147-149.DOI:10.4103/1793-5482.181135．
- [4]DE SMALEN P P,VAN ARK T J,STOLKER R J,et al.Hyperlactatemia After Intracranial Tumor Surgery Does Not Affect 6-Month Survival:A Retrospective Case Series[J].J Neurosurg Anesthesiol,2019,32(1):48-56.DOI:10.1097/ANA.0000000000000594．
- [5]ZHANG J,LIU X,ZHOU J,et al.Seizures Following Cranioplasty:Risk Factors and Prevention Exploration[J].J Craniofac Surg,2019,30(2):e170-e175.DOI:10.1097/SCS.0000000000005116．
- [6]MOHIEB H S A,BENJAMIN L,HALD J K,et al.The effect of tumor removal via craniotomies on preoperative hydrocephalus in adult patients with intracranial tumors[J].Neurosurg Rev,2018,43(6):141-151.DOI:10.1007/s10143-018-1021-6．
- [7]PIZZINGA A,PINDINELLO I,ARTICO M,et al.Francesco Durante and the First Intracranial Tumor Successfully Operated on with Long Survival(1884)[J].World Neurosurg,2019,128:308-313.DOI:10.1016/j.wneu.2019.05.054．
- [8]LI Z,SHEN D,ZHANG J,et al.Relationship between WBRT total dose,intracranial tumor control,and overall survival in NSCLC patients with brain metastases-a single-center retrospective analysis[J].BMC Cancer,2019,19(1):1104.DOI:10.1186/s12885-019-6307-8．
- [9]GOLANOV A V,BANOV S M,IL'YALOV S R,et al.Overall survival and intracranial relapse in patients with brain metastases after gamma knife radiosurgery alone[J].Zh Vopr Neirokhir Im N N Burdenko,2016,80(2):35-46．
- [10]XIAO H,DING N,LIAO H,et al.Prediction of relapse and prognosis by expression levels of long noncoding RNA PEG10in glioma patients[J].Medicine(Baltimore),2019,98(45):e17583.DOI:10.1097/MD.0000000000017583．
- [11]NIU X,WANG T,LI J,et al.An Integrative Survival Analysis with Identification of Prognostic Factors in the Patients with Coexisting Glioma and Intracranial Aneurysm[J].World Neurosurg,2018,111:e592-e600.DOI:10.1016/j.wneu.2017.12.126．
- [12]MATTEI T A,BOND B J,SAMBHARA D,et al.Benign extracerebral fluid collection in infancy as a risk factor for the development of de novo intracranial arachnoid cysts[J].J Neurosurg Pediatr,2013,12(6):555-564.DOI:10.3171/2013.8.PEDS1399．
- [13]ABOUSHOUSHA T,HAMMAM O,SAFWAT G,et al.Differential Expression of RAGE,EGFR and Ki-67in Primary Tumors and Lymph Node Deposits of Breast Carcinoma[J].Asian Pac J Cancer Prev,2018,19(8):2269-2277.DOI:10.22034/APJCP.2018.19.8.2269．
- [14]CHOI S Y,KIM J I,HWANG S W.The Comparison of Risk Factors for Ischemic Stroke or Intracranial Hemorrhage in Korean Stroke Patients[J].Biomed Sci Lett,2018,24(9):1151-1152．
- [15]CHEN L F,YANG Y,YU X G,et al.Multimodal treatment and management strategies for intracranial hemangiopericytoma[J].J Clin Neurosci,2015,22(4):718-725.DOI:10.1016/j.jocn.2014.11.011．
- [16]KHALID M H,TOKUNAGA Y,CAPUTY A J,et al.Inhibition of tumor growth and prolonged survival of rats with intracranial gliomas following administration of clotrimazole[J].J Neurosurg,2005,103(1):79-86.DOI:10.3171/jns.2005.103.1.0079．
- [17]HIRSHMAN B R,WILSON B R,ALI M A,et al.Cumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases[J].Neurosurgery,2018,83(2):237-244.DOI:10.1093/neuros/nyx380.