术前磁共振特征与成人胶质母细胞瘤患者生存期的相关性分析

目的探讨术前MRI特征与成人胶质母细胞瘤(GBM)患者生存期的相关性。方法回顾性分析2016年1月—2020年1月陆军军医大学第一附属医院神经外科收治的123例IDH野生型GBM患者的临床病例资料。采用Kaplan-Meier法评估生存时间，Log-rank分析肿瘤MRI特征、位置、大小、水肿程度、KPS评分、手术切除程度对生存期的影响。采用Cox回归分析与GBM患者生存期相关的危险因素。结果单因素分析显示术前MRI特征(P=0.000)、肿瘤位置(P=0.046)、手术切除程度(P=0.000)是与生存期显著相关的影响因素。Cox回归分析示，MRI显示中央坏死(HR=2.157，95% CI=1.214~3.831，P=0.009)和多发(HR=6.185,95% CI=3.061~12.497,P=0.000)是影响GBM患者生存期的危险因素。结论术前MRI显示肿瘤有中央坏死和多发肿瘤是GBM生存期短的标志。

Objective To investigate the correlation between preoperative MRI features and survival time of adult glioblastoma patients. Methods The clinical data of 123 IDH wild type GBM patients admitted to the Department of Neurosurgery, the First Affiliated Hospital of the Army Military Medical University from January 2016 to January 2020 were analyzed retrospectively. Kaplan Meier method was used to evaluate the survival time, and log rank was used to analyze the influence of tumor MRI characteristics, location, size, edema, KPS score, and extent of surgical resection degree on the survival time. Cox regression was used to analyze the risk factors related to the survival of GBM patients. Results Univariate analysis showed that preoperative MRI features(P=0.000), tumor location(P=0.046), and surgical resection degree(P=0.000) were significantly related to survival time. Cox regression analysis showed that MRI showed that central necrosis(HR=2.157, 95% CI=1.214-3.831, P=0.009) and multiple necrosis(HR=6.185, 95% CI=3.061-12.497, P=0.000) were risk factors affecting the survival of GBM patients. Conclusion MRI shows central necrosis and multiple tumors, which are the hallmarks of poor prognosis of GBM.