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基于动态磁共振增强评估神经胶质瘤的预后。

Evaluation of the Prognosis of Neuroglioma Based on Dynamic Magnetic Resonance Enhancement.

机构信息

Department of Neurosurgery, Jinan City People's Hospital (Jinan People's Hospital Affiliated to Shandong First Medical University), Jinan, Shandong Province, China.

Department of Neurosurgery, Zouping People's Hospital of Shandong Province, Zouping, Shandong Province, China.

出版信息

World Neurosurg. 2020 Jun;138:663-671. doi: 10.1016/j.wneu.2020.01.087. Epub 2020 Jan 22.

Abstract

This paper explores the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the prognosis of glioma, and judges the relevant factors affecting the prognosis of glioma. This paper used a Cox proportional hazards model to retrospectively analyze clinical data of 81 patients with complete neuroglioma from the same neurosurgery medical team from January 2012 to November 2018, including DCE-MRI data. To determine the prognostic factors, P < 0.05 was used as the statistical standard, and the survival curve of statistically significant factors was drawn by Kaplan-Meier method. The Cox proportional hazard model analysis showed the preoperative Karnofsky Performance Status Scale (KPS) score, age, tumor pathologic grade, postoperative radiotherapy, temozolomide use, and Ki-67 expression had an impact on the prognosis of patients with neuroglioma. Multivariate analysis and DCE-MRI data showed that age, tumor grade, preoperative KPS score, postoperative radiotherapy, and Ki-67 expression were prognostic factors for patients with glioma. The older the age, the higher the pathologic grade, the higher the Ki-67 expression level, and the lower the KPS score before surgery, the worse the prognosis. Postoperative radiotherapy and appropriate temozolomide chemotherapy will help improve the prognosis of patients with neuroglioma.

摘要

本文探讨了动态对比增强磁共振成像(DCE-MRI)对脑胶质瘤预后的诊断价值,并判断影响脑胶质瘤预后的相关因素。本文采用 Cox 比例风险模型回顾性分析了 2012 年 1 月至 2018 年 11 月同一神经外科医疗团队的 81 例完整神经胶质瘤患者的临床资料,包括 DCE-MRI 数据。为了确定预后因素,以 P<0.05 为统计学标准,通过 Kaplan-Meier 方法绘制有统计学意义的因素的生存曲线。Cox 比例风险模型分析显示,术前卡诺夫斯基表现状态评分(KPS)、年龄、肿瘤病理分级、术后放疗、替莫唑胺使用和 Ki-67 表达对神经胶质瘤患者的预后有影响。多因素分析和 DCE-MRI 数据显示,年龄、肿瘤分级、术前 KPS 评分、术后放疗和 Ki-67 表达是影响脑胶质瘤患者预后的因素。年龄越大,病理分级越高,Ki-67 表达水平越高,术前 KPS 评分越低,预后越差。术后放疗和适当的替莫唑胺化疗有助于改善神经胶质瘤患者的预后。

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