全身炎症反应指数对胶质瘤患者临床预后影响及与IDH1突变的关系

摘要

目的 探讨全身炎症反应指数(SIRI)对胶质瘤患者临床预后影响及与IDH1突变的关系.方法 收集2006年8月—2015年11月于我院神经外科行手术治疗的80例神经胶质瘤患者.应用ROC曲线确定SIRI判断患者术后生存状态的最佳临床分界值,并依此分组.采用Kaplan-Meier和Log-rank法分析两组患者术后生存情况.Cox比例风险回归模型分析临床预后因素.应用免疫组织化学和DNA测序方法检测IDH1突变情况.结果 低SIRI组术后中位无进展生存时间(Progress free survival,PFS)和中位总生存时间(Overall survival,OS)分别为46.90个月和57.90个月,而高SIRI组术后中位PFS和中位OS分别为31.78个月和47.22个月;两组术后中位PFS和中位OS比较差异具有统计学意义(P<0.05).经单因素和多因素分析,年龄、手术情况、WHO分级、SIRI、IDH1突变是神经间质瘤独立预后的因素.低SIRI组伴有IDH1突变的神经胶质瘤患者预后较好.结论 SIRI是神经胶质瘤独立的预后因素,具有简单、方便、可重复性强等特点,可用来预测神经胶质瘤患者的预后.%Objective The objective of this study was to investigate the effect of systemic inflammation response index(SI-RI)on clinical prognosis of patients with glioma and its relationship with dehydrogenase 1(IDH1)mutation.Methods Eighty patients with glioma who underwent surgery in the department of Neurosurgery were collected from August 2006 to November 2015.The best clinical cutoff value for SIRI was determined using operating characteristic curve(ROC)and grouped accordingly.The Kaplan-Meier and log-rank methods were used to analyze the postoperative survival of the two groups of patients.The independent clinical prognos-tic factors were evaluated by Cox′s proportional hazards regression model.The IDH1 mutation was detected by immunohistochemistry and DNA sequencing.Results SIRI was an independent prognostic factor of glioma,and the best clinical cutoff value was 0.67 × 109/L.The median progress free survival(PFS)and overall survival(OS)of patients with low SIRI group were 46.90 months and 57.90 months,and the median PFS and OS of patients with high SIRI group were 31.78 months and 47.22 months,respectively.There was significant difference between the two groups in the median survival time of PFS and OS by log-rank method(P<0.05).Univa-riate and multivariate analysis showed that age,gender,type of surgery,WHO stage,SIRI and IDH1 mutation were the independent prognostic factors in neurostein stromal tumors.Patients with low-grade SIRI and glioma with IDH1 mutation have a better prognosis than other conditions.Conclusion SIRI is an independent prognostic factor of glioma.It is simple,convenient and reproducible,and may be used to predict the prognosis of patients with glioma.