Analysis Of Prognostic Factors In 123 Patients With Low Grade Glioma

Glioma is the most common primary intracranial tumor. WHO divided it into four steps. The I- II grade of low grade gliomas(LGG) are mostly benign. LGG accounted for 10%-20% of the primary tumor. LGG can disperse on supratentorial regions, but the astrocytomas occur in the supplementary motor area and insula. Oligodendroglioma occur in the convex surface layer, especially in frontal lobe.The patients with low grade glioma do not necessarily have clinical manifestations in the early. It’s 14.0+/-7.8year for silence. LGG usually are diagnosed by seizure history. MRI is the main means of radiological diagnosis for LGG. Glioma occurrence, development and prognosis is assiociation with some proto oncogenes, tumor suppressor genes and gene expressions which regulate the cell cycle. The goal of treating the patients with LGG is to prolong the overall survival, at the same time to ensure the quality of life of patients(QOL).Objective: To study the prognostic factors of the patients with low grade glioma.Methods: 123 patients with low-grade glioma were involved in the study,who were treated in the Second Hospital of Hebei Medical University from January 2010 to January 2014. Using SPSS,the relevances of 15 possible factors and progression free survival(PFS)were analyzed in the research,such as gender, age, pathological type, time since attacked to see a doctor, epilepsy before operation, KPS score, tumor diameter, tumor resection range, radiation and chemotherapy after surgery, the expression conditions of tumor markers GFAP, S- 100, MMP- 9, MGMT, PCNA and P170.Result: There are 123 patients.Univariate analysis showed that the number of patients whose age less then fifty is 93,and the average of PFS is 28.14 months;the number other patients is 30,and the average of PFS is 16.50 months(P<0.001).84 of 123 patients do not accompagne with epilepsy before operation, and its average of PFS is 23.01months;39 of 123 patients accompagne with epliepsy before operation,and its average of PFS is 30.23(P=0.17). According to the gender, 70 cases are male, median progression free survival is 25.55 months, 53 cases are female, average progression free survival time is 24.96 months(P=0.837). According to the different pathological type, 48 cases with oligodendroglioma,which median progression free survival is 25.50 months,which 75 cases of astrocytoma, median progression free survival time is 25.17 months(P=0.904). According to the time before patients with symptoms going to hospital, to 1 months as the boundary, 65 patients less than 1 months, median progression free survival is 24.44 months, 58 patients more than 1 months, median progression free survival is 26.09 months(P=0.564). According to the preoperative KPS score, 14 patients less than 70, median progression free survival is 22 months, 109 patients more than 70, median progression free survival is 25.72 months(P=0.407). According to the maximum diameter of tumor, 67 cases are less than or equal to 5cm and the average progression free survival is 25.37 months, 46 cases more than 5cm, median progression free survival is 25.18 months(P=0.949). According to the classification of tumor resection, tumor resection in 22 patients, median progression free survival is 22.09 months, the tumors were totally removed in 101 patients, median progression free survival is 26.00 months(P=0.294). According to the different groups of postoperative radiotherapy and chemotherapy, 50 patients without radiotherapy and chemotherapy, median progression free survival time is 22.32 months, 46 cases of patients with radiotherapy, median progression free survival is 28.28 months, 14 cases of chemotherapy patients, median progression free survival time is 28.93 months, 13 cases of radiotherapy and chemotherapy for patients, the average progression free survival time is 22.31 months(P=0.199). If only by radiotherapy, chemotherapy alone group, 64 patients without radiotherapy, median progression free survival time is 23.76 months, 59 cases of patients with radiotherapy, median progression free survival is 26.97 months(P=0.261); chemotherapy in 96 patients, median progression free survival is 25.18 months, 27 cases of chemotherapy patients, average progression free survival is 25.74 months(P=0.870). Analysis 123 patients with multiple factors, age(P=0.001), epilepsy before operation(P=0.015), pathological type(P=0.017) showed statistical significance. Rank sum test of tumor markers, PCNA is statistically significant for progression free survival prolongation(P=0.022), and GFAP(P=0.807), S-100(P=0.477), MMP-9(P=0.588), MGMT(P=0.427)and P170(P=0.588) have no statistical significance.Conclusion: Younger patien,having epilepsy before operation, whose pathological type was oligodendroglioma and lower expression of PCNA are better independent prognostic factors. PCNA is negatively correlated with progression-free survival.