| Object:To investigate the clinical diagnosis,treatment and prognosis of multiple cerebral gliomas patients,so as to provide reference for diagnosis and treatment of multiple cerebral gliomas.Methods:Retrospective analysised 102 multiple cerebral gliomas patients proved by pathology from January 2012 to January 2017 who operated in the department of Neurosurgery,the Henan Provincial People's Hospital.There were 51 males and 51 females;56 patients was no less than 50 age,and 46 was lower than50;Preoperative KPS score of no less than 70 score has 56,and 46 has less than 70 score.Pathological low level group patients has 31,and pathological high level group has 71;gross-total resection was achieved in 9 patient,near gross-total resection in 30,and partial resection in 63;75 patients received post-operative radiotherapy accompanied with chemotherapy,and other 27 patients is not received.Analyse these factors including gender,sex,age,pathological grade,preoperative KPS,extent of tumor resection,tumors number,post-operative radiotherapy accompanied with chemotherapy,conduct single factor analysis by Log-rank test analysis,survival rate,and survival curve were plotted.Cox proportional hazards model was used for multivariate analysis.P < 0.05 was considered statistically significant.Results:In the study,MRI images showed that 78 patients(76.5%)had high signal intensity in T2 WI,and 83 patients(85.3%)had unclear boundary.There were58 cases(81.7%)with irregular or flower ring enhancement in the high grade pathological group,while 22 cases(71.1%)showed no obvious enhancement in the low grade pathology group.Univariate analysis of patient survival factors: The median survival of the lower-grade group in the higher-grade group was longer(P=0.003);the median survival was less than 50 years in the patients aged <50 years.The median survival time was prolonged(P=0.039).The median survival of patients with a preoperative KPS score of ?70 was significantly longer than the median survival of patients with a preoperative KPS score<70(P<0.001);the number of lesions was two.The median survival time in the patient group was longer than that in patients with a number of lesions ?3(P=0.043);the survival of patients in the excision group was significantly longer than in the subtotal group and partial resection(P<0.001);The survival period of chemotherapy patients was significantly better than that of patients without chemotherapy(P<0.001).Multivariate analysis using COX showed extent of tumor resection(P=0.030),radiotherapy and chemotherapy(P=0.023),preoperative KPS score(P=0.001),pathological grade(P=0.040),tumors number(P= 0.036)Five factors are independent predictors of prognosis in patients with MCG.Conclusion:1.Multiple cerebral gliomas have relatively independent lesions and have unique imaging features.MRI has a high value for the diagnosis and differential diagnosis of multiple cerebral gliomas.2.The lesions on the T1 WI image of the MRI images of the MCG can be unclear.The hyperintense signal on the T2 WI image shows unclear lesion borders.The MCG high-grade pathological group shows irregular or rose-ring enhancement.The low-grade pathological group shows no obvious enhancement.3.preoperative KPS,extent of tumor resection,pathological grade,tumors number,radiotherapy and chemotherapy were independent prognostic factors for MCG.4.The higher the extent of tumor resection,postoperative adjuvantradiotherapy and chemotherapy,is beneficial to the prognosis of MCG patients. |
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