Lote K, Stenwig A E, Skullerud K, Hirschberg H
Department of Oncology, Norwegian Radium Hospital, Oslo, Norway.
Eur J Cancer. 1998 Jan;34(1):98-102. doi: 10.1016/s0959-8049(97)00374-2.
The aim of this study was to evaluate the prevalence and prognostic significance of epilepsy in 1028 patients diagnosed in the computer tomography (CT) era with histological low- or high-grade intracranial gliomas. Survival analysis included Kaplan-Meier plots, log-rank tests, logistic regression and Cox's analysis as implemented in the SPSS statistical package. Epilepsy was a positive univariate (P < 0.0001) and multivariate, (P < 0.03) prognostic factor for survival in the total patient group (n = 1028, relative risk of death 0.83, 95% confidence interval (CI) 0.70-0.98) as well as in the high-grade patient group (n = 649, relative risk of death 0.80, 95% CI 0.66-0.96), but not in the group of low-grade glioma patients (P > 0.2). The prevalence of epilepsy in glioblastoma patients was 251/512 (49%), 95/137 (69%) in anaplastic gliomas, and 322/379 (85%) in patients with low-grade gliomas, with 97 of the 102 T1 low-grade subgroup (95%) having epilepsy, indicating that the presence of epilepsy may select patients for early radiological diagnosis. The frequency of epilepsy at presentation decreased with age in high-grade glioma patients, and increased with age in low-grade glioma patients to a plateau in the fourth decade of life (P < 0.01). The prevalence of epilepsy in patients with histological intracranial gliomas varied with patient age and tumour histology, with low-grade patients having the highest prevalence. Epilepsy was a significant positive prognostic factor except in patients with low-grade gliomas, and may select low-grade patients for early diagnosis.
本研究旨在评估1028例在计算机断层扫描（CT）时代被诊断为组织学低级别或高级别颅内胶质瘤患者中癫痫的患病率及其预后意义。生存分析包括在SPSS统计软件包中进行的Kaplan-Meier曲线、对数秩检验、逻辑回归和Cox分析。癫痫是总患者组（n = 1028，死亡相对风险0.83，95%置信区间（CI）0.70 - 0.98）以及高级别患者组（n = 649，死亡相对风险0.80，95% CI 0.66 - 0.96）生存的单因素（P < 0.0001）和多因素（P < 0.03）阳性预后因素，但在低级别胶质瘤患者组中并非如此（P > 0.2）。胶质母细胞瘤患者中癫痫的患病率为251/512（49%），间变性胶质瘤患者中为95/137（69%），低级别胶质瘤患者中为322/379（85%），102例T1低级别亚组患者中有97例（95%）患有癫痫，这表明癫痫的存在可能促使患者进行早期影像学诊断。高级别胶质瘤患者就诊时癫痫的发生率随年龄降低，而低级别胶质瘤患者中癫痫发生率随年龄增加，在生命的第四个十年达到平稳状态（P < 0.01）。组织学颅内胶质瘤患者中癫痫的患病率因患者年龄和肿瘤组织学而异，低级别患者的患病率最高。除低级别胶质瘤患者外，癫痫是一个显著的阳性预后因素，并且可能促使低级别患者进行早期诊断。
