The Analysis On The Long-term Survival Cause Of The Patients With Malignant Glioma

In central nervous system disease, brain glial tumor is about60%of originalnervous system tumor. It is the most common malignant tumors. Brain glial tumor isfrom neural epithelial tissue cells, it has the characters of bad prognosis and highrecurrence rate. It is a great threat to the patients’ lives, so the treatment of malignantbrain glial tumor has been a hot problem. In recent years, many research shows thatsurgery resection degree, the chemotherapy and the radiotherapy after surgery, tumorpathology classification, physical quality of patients and age were the factors forprognosis of malignant brain glial tumor.Glioma cells can cause the decrease of tight junction protein Claudin-5inblood-brain barrier, it can also cause the damage of blood-brain barrier tight junctionstructure, but there is a negative relationship between the distance from tumor Centerand connexin Claudin-5expression and blood-brain barrier damage[1]. Numerousclinical studies shows that glioma tissues in vascular basement membrane is continuousfull line, there are no tumor cells in endovascular, it is similar to those with normalbrain tissues of vascular basement membrane, the glioma cells have the formation ofinducement and form the blood-tumor barrier[2]. With the method of blood-tumorbarrier open chemotherapy after operation, the chemotherapy drugs can get into theresidual tumor cells. The papaverine injection plays a strong role in vasodilator. Itmakes small arteries and small capillaries expanding rapidly in order to make theblood-brain barrier open.One of the current hot spots of cancer research is the relationship betweenangiogenesis and tumor biological behavior. VEGF is the most direct and mostimportant blood vessel growth-stimulating factor and its effects will control theangiogenesis. It will provide sufficient blood to tumors and promote the growth ofcancer cell invasion and proliferation.Numerous clinical studies have confirmed that the VEGF expression could increase with different degrees in pancreatic cancer andcolon cancer, lung cancer, breast cancer and many other diseases. The scholars study onVEGF expression in malignant glioma, as malignant glioma with rich vessels and relyon angiogenesis, so there is a significant increase in VEGF expression. Meanwhile, withthe increase of malignant glioma degree, VEGF positive rate also increased and the badprognosis also increase with the VEGF expression[3].Objective：To study on the effects of malignant glioma surgery, postoperativechemotherapy, chemotherapy time, pathological level, VEGF expression level, age,gender and influence of psychological factors.Method：We made a retrospective analysis on96patients with malignant gliomafrom September1988to September1992in our hospital. The surgical methods,pathology results, VEGF expression, survival time and chemotherapy of opening theblood-brain barrier were analyzed to find the long-term survival causes for the patientswith malignant glioma.Results：1. There were22cases with complete resection,20cases with most partresection,54cases with sub-total resection in96cases. The survival ones are withcomplete resection patents.2. In96patients, there were35cases with malignant gliomaastrocytic tumor,61cases with glioblastoma tumor. The survival ones are3casesAstrocytoma and7cases glioblastoma tumor.3. In96patients with malignant glioma,5-year survival rate was25%（24/96）;10-year survival rate was11.45%（11/96）;20-year survival rate was10.4%（10/96）. There are still10cases living, one case diedof multiple organ failure (without recurrence of tumors) about13years after the surgery.4. There were20cases with VEGF expression (+),6cases of them survived for morethan20years; There were34cases with VEGF expression (++),2cases of themsurvived for more than20years; There were42cases with VEGF expression (+++),2cases of them survived for more than20years. There were2cases with chemotherapyof opening of blood-brain barrier which was less than3times, there were6cases greaterthan or equal to3times and less than5times, there were2cases greater than or equal to5times.Conclusion： Whole resection, opening of the blood brain barrier arterychemotherapy after sugery, low expression of VEGF were associated with the survivaltime of malignant gliomas. The use of papaverine opening of the blood brain barrierarterial chemotherapy has a good effect on malignant glioma.