| Objective To explore the related factors of postoperative epilepsy recurrence in supratentorial low-grade glioma associated with adult epilepsyMethods Retrospective analysis the clinical data of 112 cases of epileptic-related supratentorial low-grade glioma adult patients were confirmed by pathology of the Department of Neurosurgery,the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2017.Statistical analysis of possible factors of postoperative epilepsy recurrence using spss17.0 statistical software,including gender,age,type of seizure,duration of epilepsy(the time from first epilepsy to surgery),Proliferation index(ki-67)and whether radiotheraphy or chemotherapy or not.Single factor analysis was performed by chi-square test.Using logistic multivariate analysis analyze the meaningful factors of single factors analysis.P<0.05 was considered statistically significant.Results The chi-square test was used to analyze the clinical factors of 112 patients with pathological diagnosis of epilepsy as the first symptom of low-grade glioma.Grouped by gender: 70 males and 42 females with preoperative epilepsy,24 males and13 females with postoperative epilepsy,c(17)=0.132,p=0.717;grouped by age:preoperative epilepsy>39 years old 57 cases,≥ 55 cases were 18-39 years old,postoperative epilepsy >12 years old 12 cases,≥18-39 years old 25 cases,c(17)=7.534,p=0.006;grouped according to epilepsy course: preoperative epilepsy 45 cases <1week,40 cases ≥1 week-6 months,7 cases ≥ 6 months-one year,20 cases ≥ 1year,postoperative recurrence of epilepsy were: 11 cases,11 cases,4 cases,11 cases,c(17)= 8.256,p = 0.041;According to the type of epilepsy: preoperative epileptic seizures 33 cases,79 cases of total seizures,postoperative epilepsy recurrence,8 cases,29 cases,c(17)=1.635,p=0.201;grouped according to tumor location: preoperative epilepsy frontal 65 cases,33 cases of temporal lobe,9 cases of parietal lobe,5 cases of insular lobe,postoperative recurrence,24 cases,9 cases,2 cases,2 cases,c(17)=1.525,p=0.677;grouped according to degree of resection: preoperative epilepsy:78 cases of gross-total resection,27 cases of subtotal resection,and 7 cases of most resection.The postoperative epilepsy recurrence was 16 cases,16 cases,5 cases,c(17)=18.587,p=<0.001;according to pathological type: preoperative epilepsy 67 cases of astrocytoma,34 cases of oligodendroglioma and 11 cases of oligodendrosic astrocytoma.The postoperative recurrence of epilepsy was 22 cases,9 cases,6 cases,c(17)=2.964,p=0.227;grouped according to pathological level: preoperative epilepsy :3 cases of WHO I,109 cases of WHO II,and postoperative epilepsy : 1 case,36 cases,c(17)<0.001,p=0.991;grouped according to value-added index(ki-67): preoperative epilepsy <9% 93 cases,19 cases of≥9%,postoperative epilepsy recurrence,26 cases,11 cases,c(17)=6.392,p=0.011;grouped according to chemotherapy or not: 108 cases of preoperative epilepsy chemotherapy,4cases of no chemotherapy,postoperative epilepsy recurrence 36 cases,1 case,c(17)=0.121,p=0.728;grouped according to radiotherapy or not: 54 cases of preoperative epilepsy radiotherapy,58 cases of no radiotherapy,postoperative epilepsy recurrence,28 cases,9 cases,c(17)= 16.689,p<0.001;single factors analysis showed that age,stage of epilepsy,degree of tumor resection,proliferation index(ki-67),radiotherapy or not were statistically significant for postoperative epileptic recurrence of supratentorial low-grade glioma associated with adult epilepsy.Significance(p<0.05);gender,type of seizure,location of tumor,pathological grade,pathological type,chemotherapy or not There was no significant difference in postoperative epilepsy associated with supratentorial low-grade glioma associated with human epilepsy(p>0.05);logistic regression analysis showed: age(OR=0.189,P<0.05,95% CI: 0.059-0.602),The course of epilepsy(OR=0.509,P<0.05,95% CI: 0.316-0.820),degree of tumor resection(OR =0.292,P<0.05,95% CI: 0.103-0.829),proliferation index(ki-67)(OR =0.160,P<0.05,95% CI:0.046-0.554)is a risk factor for postoperative recurrence of epilepsy.Conclusions For adult patients with epilepsy as the first symptom and clinical diagnosis of low-grade glioma,surgical treatment should be performed as soon as possible,and the tumor should be safely and maximally removed without affecting nerve function.The patients age is ≥39 years old and the tumor is not with full cut,longer epilepsy duration,and proliferative index(ki-67)≥ 9% should be treated with anti-epilepsy after surgery.The withdrawal or reduction of anti-epilepsy drugs should be carefully carried out under the full evaluation of professional doctors to avoid recurrence of epilepsy. |
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