摘要：

目的: 探讨成人胶质母细胞瘤患者术后生存时间的影响因素。方法: 纳入2019年1月至2022年4月在徐州医科大学附属医院予以手术切除的96例胶质母细胞瘤患者，通过第二代测序技术检测TERT启动子突变、EGFR扩增及第7号染色体获得伴第10号染色体缺失（+7/-10），采用Kaplan-Meier生存曲线计算中位生存期，单因素和多因素Cox比例风险回归分析筛查术后生存时间的影响因素。结果: Kaplan-Meier生存曲线显示，胶质母细胞瘤患者中位生存期为14.50个月。Cox比例风险回归分析显示，年龄> 60岁（HR = 2.720，95%CI：1.418~5.216；P = 0.003）、术前Karnofsky功能状态评分 < 80分（HR = 2.481，95%CI：1.455~4.232；P = 0.001）、TERT启动子突变（HR = 2.846，95%CI：1.455~5.569；P =0.002）、EGFR扩增（HR = 3.263，95%CI：1.770~6.015；P = 0.000）、存在+7/-10（HR = 2.349，95%CI：1.272 ~4.337；P = 0.006）是胶质母细胞瘤患者术后生存时间缩短的危险因素，肿瘤全切除（HR = 0.246，95%CI：0.132~0.458；P = 0.000）、术后辅以放化疗（HR = 0.368，95%CI：0.212~0.639；P = 0.000）是术后生存时间延长的保护因素。结论: TERT启动子突变、EGFR扩增、存在+7/-10的胶质母细胞瘤患者预后较差；临床常规检测胶质母细胞瘤患者TERT启动子是否突变、EGFR是否扩增及染色体拷贝数变异，有助于准确评估患者预后。

关键词: 胶质母细胞瘤, 末端转移酶端粒, ErbB受体, 生物标记，肿瘤, 病理学，分子, Kaplan-Meiers评估, 成年人

Abstract:

Objective: To investigate the related influencing factors that affect the prognosis of adult glioblastoma (GBM) patients. Methods: We conducted a retrospective analysis of the molecular pathological data and follow-up information from 96 GBM patients who underwent tumor surgical resection in The Affiliated Hospital of Xuzhou Medical University between January 2019 and April 2022. The presence of TERT promoter mutation, EGFR amplification, and chromosome 7 gain with chromosome 10 deletion (+7/-10) were detected using next-generation sequencing (NGS) technology. The median survival time (MST) of the patients was calculated using Kaplan-Meier survival curve, and univariate and multivariate Cox proportional hazards regression analyses were performed to identify related influencing factors affecting postoperative survival time. Results: The Kaplan-Meier survival curve indicated that the MST for GBM patients was 14.50 months. Cox proportional hazards regression analysis revealed that age > 60 years old (HR = 2.720, 95%CI: 1.418-5.216; P = 0.003), preoperative Karnofsky Performance Status (KPS) score < 80 (HR = 2.481, 95%CI: 1.455-4.232; P = 0.001), TERT promoter mutation (HR = 2.846, 95%CI: 1.455-5.569; P = 0.002), EGFR amplification (HR = 3.263, 95%CI: 1.770-6.015; P = 0.000), and the presence of +7/-10 (HR = 2.349, 95%CI: 1.272-4.337; P = 0.006) were identified as risk factors associated with shortened postoperative survival time. In contrast, gross total resection of the tumor (HR = 0.246, 95%CI: 0.132-0.458; P = 0.000) and postoperative combined chemoradiotherapy (HR = 0.368, 95%CI: 0.212-0.639; P = 0.000) were protective factors associated with prolonged postoperative survival time. Conclusions: GBM patients exhibiting TERT promoter mutation, EGFR amplification and +7/-10 have a poorer prognosis. Routine clinical testing of TERT promoter status, EGFR amplification, and chromosomal copy number variations (+7/-10) are beneficial for accurately assessing patient prognosis.

Key words: Glioblastoma, Telomerase, ErbB receptors, Biomarkers, tumor, Pathology, molecular, Kaplan-Meiers estimate, Adult