| Background and purpose:Glioma, which have a highly malignant, can damage central nervous system quickly, endanger the patients’life seriously. Currently,the treatment is still surgical excision. As the boundaries between tumor and brain tissue is unclear, and invasive growth, it is difficult to achieve total removal. The evaluation of clinical efficacy mostly use survival as a criteria. With the rapid development of medical,using KPS reflect the quality of glioma patients’life, and evaluated the efficacy of the rehabilitation process, it is rarely about the relevant reports. Based on the glioma patients who are treated in Shanxi Tumor Hospital neurosurgery treatment and follow-up data, looking for factors which influence the survival time and prognosis of glioma patients, predict the survival rate of glomia patients and serve the reference for individual therapy and prognostic.Materials and Methods:60patients of glioma were collected from the Shanxi Tumor Hospital, who were treated from June2010to August2013.Get58complete cases of glioma patients follow-up data. All patients were diagnosis with glioma disease, the patient underwent surgery, postoperative pathological examination of glioma, and appropriate treatment. The quantitative variables which are normal distribution are described by,or by M±OR. Calculate rate or constituent ratio of the categorical variable. The two sets of rate and composition are inferred by chi-square test, quantitative data were analyzed by t-test. Affect the diagnostic evaluation of results of multivariate are analyzed by Cox proportional hazards regression.According covariate’s characteristics, using Kaplan-Meier method and Log-rank test to estimate and compare the survival time.The introduction of variable standards take a=0.10, excluding standards take a=0.20.All data were analyzed using SPSS13.0.Results and analysis:58patients of glioma were collected from the Shanxi Tumor Hospital, who were treated from June2010to August2013. In this study, the youngest patient was13years old, the oldest patients was74year old, the average median age (49.00±18.75) years old. There are over31cases were49years old,27cases under the age of49years old.35cases were male patients,23cases were female patients, the sex ratio was1.52:1. The glioma patients median survival time was (208±276) days, the shortest survival time was9days, the longest survival time was1029days,the shortest follow-up time was42days, the longest follow-up time was1098days.1. Clinical epidemiological characteristics of glioma patients showed that:The median survival time between less than49years glioma patients’KPS scores and over49years patients have a statistically significant difference(P<0.05), KPS score can be considered as an evaluation of brain glioma patients after an indicator of quality of life.Clinical symptom were performance in high intracranial pressure,such as headache, nausea, vomiting, blurred vision and so on, often accompanied with limb movement disorder, epilepsy and other neurological deficit symptoms. Epilepsy patients’KPS score difference from no occurred patients, Z=-3.428, P<0.001. the median survival time between Limb movement disordered patients’KPS score and no limb movement patients, Z=-2.431, P=0.019, it can considered that Limb movement disordered patients’KPS score lower than no physical activity patients.After analyses of the tumor’s resection, whether accompanied with cystic peritumoral edema and tumor histopathology, comparison between the median survival time by KPS score, the analyses with tumor resection, χ2=16.695, P<0.001, can be considered different tumor resection, the median survival time of patients KPS score is different; patients without cystic KPS score higher than patients with cystic tumor, Z=-2.279, p=0.022. After cystic patients median survival time of KPS scores, Z=-1.777, p=0.076, patients without cystic tumor’s KPS score higher than no cystic patients; mild peritumoral edema in patients’KPS score higher than degree of edema in patients with severe,χ2=5.365, P=0.068, mild peritumoral edema in patients with KPS scores higher than the median survival time of patients with edema severe; pathological examination astrocytoma two grade17cases, three and four grade astrocytoma41cases, the pathology results before the surgery KPS scores χ2=5.218, P=0.074, pathological tumor grade results two grade astrocytoma patients KPS score higher in patients with astrocytoma grade three and four grade astrocytoma patients with KPS, the median survival time by KPS scores, χ2=12.774, P=0.002, pathological tumor grade astrocytoma results two, three grade astrocytoma patients with KPS score higher in patients four grade astrocytoma patients with KPS score.2.KPS score, age and physical functional status, extent of surgical resection and pathological diagnosis and evaluation of the efficacy of glioma patients.The KPS score more than70points were44cases, accounting for75.8%, with a median survival time363days, KPS score less than70points were14cases, accounting for24.13%, with a median survival time of19days, P=0.002, considered KPS score can check and forecast glioma cell tumors postoperative quality of life and survival time, can also be recommended as an important indicator of the efficacy were evaluated in patients with glioma.Full implementation of the surgical cutting of glioma patients, the median survival time up to706days, not only have a higher survive quality, and its prognosis is significantly better than the other two methods. Therefore, surgery is still the preferred and effective method. Have great significance with the quality of patients life. Postoperative pathological examination, astrocytoma grade two17cases, the median survival time was774days, astrocytoma grade three17cases, the median survival time was362days, astrocytoma grade four41cases, the The median survival time was241days. P=0.067. Showed pathological diagnosis were evaluated for the survival of patients has important significance. It is an important indicator to judge the prognosis of patients with brain gliomas.3.COX regression analysis shows that age, epilepsy, limb movement disorder, the extent of tumor resection, pathological findings, Ki67, KPS score is an important factor of postoperative quality of life in glioma patients. Over49years of age, limb movement disorder, detecting Ki67greater than10%, the higher the pathological diagnosis of brain tumor grade glioma patients, their short and long term treatment and prognosis are poor, both P<0.10.4.MRI is an important indicator to judge glioma grading. Low-level and high-grade gliomas in MRI, strengthen, associated with cystic degeneration, peritumoral edema, can be used as an objective basis for judging the degree of malignancy of gliomas. High-grade gliomas a higher positive rate in GFAP, P53, S100, Ki67correlated with pathologic grade gliomas. In clinic Ki67not only used to judge the malignant of glioma, but also for the possibility of its recurrence anticipation. Provide the basis for selection of patients for treatment. Discussion and Conclusion:1.In different pathological grades of glioma patients, age, cystic tumor, edema, limb movement disorder and other factors constituting a significant difference. Glioma patients whose pathology positive expression in GFAP, P53, Ki67positively correlated with histological grade gliomas.2.Age, preoperative symptoms, MRI imaging features, pathologic diagnosis, were major prognostic factors influence glioma patients’survival and quality. Age, tumor grade, is an independent risk factor affecting the prognosis of patients with glioma.3. KPS score both predict the quality life of glioma patients with prognostic factors, and the indicators of efficacy evaluation.4.The removal degree of the tumor is an independent prognostic factor affecting the quality life of patients with glioma. |
