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与癫痫相关的胚胎发育不良性神经上皮肿瘤患者的长期癫痫发作结局及预测因素

Long-Term Seizure Outcomes and Predictors in Patients with Dysembryoplastic Neuroepithelial Tumors Associated with Epilepsy.

作者信息

Zhang Huawei, Hu Yue, Aihemaitiniyazi Adilijiang, Li Tiemin, Zhou Jian, Guan Yuguang, Qi Xueling, Zhang Xufei, Wang Mengyang, Liu Changqing, Luan Guoming

机构信息

Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.

Department of Neurosurgery, Aviation General Hospital, China Medical University, Beijing 100012, China.

出版信息

Brain Sci. 2022 Dec 22;13(1):24. doi: 10.3390/brainsci13010024.

Abstract

To determine the predictors and the long-term outcomes of patients with seizures following surgery for dysembryoplastic neuroepithelial tumors (DNTs); Methods: Clinical data were collected from medical records of consecutive patients of the Department of Neurosurgery of Sanbo Brain Hospital of Capital Medical University with a pathological diagnosis of DNT and who underwent surgery from January 2008 to July 2021. All patients were followed up after surgery for at least one year. We estimated the cumulative rate of seizure recurrence-free and generated survival curves. A log-rank (Mantel-Cox) test and a Cox proportional hazard model were performed for univariate and multivariate analysis to analyze influential predictors; Results: 63 patients (33 males and 30 females) were included in this study. At the final follow-up, 49 patients (77.8%) were seizure-free. The cumulative rate of seizure recurrence-free was 82.5% (95% confidence interval (CI) 71.8-91.3%), 79.0% (95% CI 67.8-88.6%) and 76.5% (95% CI 64.8-87.0%) at 2, 5, and 10 years, respectively. The mean time for seizure recurrence-free was 6.892 ± 0.501 years (95% CI 5.91-7.87). Gross total removal of the tumor and a short epilepsy duration were significant predictors of seizure freedom. Younger age of seizure onset, bilateral interictal epileptiform discharges, and MRI type 3 tumors were risk factors for poor prognosis; Conclusions: A favorable long-term seizure outcome was observed for patients with DNT after surgical resection. Predictor analysis could effectively guide the clinical work and evaluate the prognosis of patients with DNT associated with epilepsy.

摘要

确定胚胎发育不良性神经上皮肿瘤(DNTs)手术后癫痫患者的预测因素和长期预后;方法:收集首都医科大学三博脑科医院神经外科2008年1月至2021年7月期间连续收治的病理诊断为DNT且接受手术治疗的患者的病历资料。所有患者术后至少随访1年。我们估计了无癫痫复发的累积率并绘制了生存曲线。采用对数秩(Mantel-Cox)检验和Cox比例风险模型进行单因素和多因素分析,以分析有影响的预测因素;结果:本研究纳入63例患者(男33例,女30例)。末次随访时,49例患者(77.8%)无癫痫发作。2年、5年和10年无癫痫复发的累积率分别为82.5%(95%置信区间(CI)71.8 - 91.3%)、79.0%(95% CI 67.8 - 88.6%)和76.5%(95% CI 6(4.8 - 87.0%)。无癫痫复发的平均时间为6.892±0.501年(95% CI 5.91 - 7.87)。肿瘤全切和癫痫病程短是无癫痫发作的重要预测因素。癫痫发作起始年龄较小、双侧发作间期癫痫样放电和MRI 3型肿瘤是预后不良的危险因素;结论:DNT患者手术切除后长期癫痫预后良好。预测因素分析可有效指导临床工作并评估DNT合并癫痫患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3082/9856460/51cddcf44fe4/brainsci-13-00024-g001.jpg

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