室管膜下区受侵对脑胶质瘤预后的影响

Effect of subventricular zone invasion on prognosis of glioma patients

    摘要
  • 摘要:
      目的  探讨室管膜下区(subventricular zone, SVZ)受侵对脑胶质瘤预后的影响。
      方法  回顾性分析江西省肿瘤医院2010年1月至2015年7月收治的175例经病理诊断为脑胶质瘤患者的临床资料, 其中WHOⅡ级59例, Ⅲ级59例, Ⅳ级57例; 根据术前MRI检查病灶与SVZ的位置关系, 分为SVZ受侵组(SVZ+)及SVZ未受侵组(SVZ-), 其中SVZ (+)组75例, SVZ (-)组100例, 比较两组的生存时间及复发模式。
      结果  中位随访时间63个月; 5年总生存率(overall survival, OS)及无进展生存率(progression-free survival, PFS)分别为42.2%、37.5%;SVZ (+)组5年OS为20.9%, SVZ (-)组为57.1%(P< 0.001);而5年PFS分别为15.3%、44.1%(P< 0.001)。SVZ (+)组手术全切率更低(P< 0.001), 有更多大病灶(最大径≥ 5.0 cm)及Ⅳ级病例(P < 0.001, P=0.018)。全组共89例复发, SVZ (+)组总复发率为62.7%, SVZ (-)组为42.0%(P=0.007), 而远处复发率分别为21.3%、7.0%(P=0.004)。
      结论  SVZ受侵是影响脑胶质瘤OS、PFS的不良预后因素, 且与低的全切率、大病灶及Ⅳ级病变呈正相关; SVZ受侵增加了总复发及远处复发概率。

     

    Abstract:
      Objective  To investigate the prognostic value of subventricular zone (SVZ) invasion in glioma patients.
      Methods  The clinical data of 175 patients with glioma diagnosed based on pathology in Jiangxi Province Cancer hospital between January 2010 and July 2015 were analyzed retrospectively.There were 59 cases of World Health Organization (WHO) grade Ⅱ, 59 cases of WHO grade Ⅲ, and 57 cases of WHO grade Ⅳ at the first diagnosis.There were 75 cases of SVZ invasion (SVZ+) and 100 cases of SVZ non-invasion (SVZ-) according to preoperative magnetic resonance imaging.The survival outcomes of both cohorts were compared using the Logrank test.The correlation between the recurrence pattern and SVZ involvement was analyzed using Chi-square tests.
      Results  The median follow-up time was 63 months.The 5-year overall survival (OS) and progression-free survival (PFS) rates were 42.2% and 37.5%, respectively.These were 20.9% and 15.3% in the SVZ+group, compared with 57.1% and 44.1% in the SVZ-group, respectively (P< 0.001 and P< 0.001, respectively).The SVZ+group had fewer cases of total resection, larger lesions (maximum diameter greater than 5.0 cm), and more cases of grade Ⅳ(P< 0.001, P< 0.001, and P=0.018, respectively).There were 89 cases of recurrence.The total recurrence rate was 62.7% in the SVZ+group, compared with 42.0% in the SVZ-group (P=0.007);the distant recurrence rates were 21.3% and 7.0%(P=0.004), respectively.
      Conclusions  SVZ invasion is a poor prognostic factor for OS and PFS in gliomas, which is positively correlated with a low total resection rate, large lesions, and grade Ⅳ lesions, and increases the probability of total recurrence and distant recurrence.

     

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