■发现低度癫痫相关脑肿瘤(LEAT)是第二常见的病变相关癫痫。LEATs的恶性潜能非常低,总体生存率良好,因此,治疗的重点更多集中在癫痫发作的结果,而不是肿瘤预后。
■本研究旨在评估LEAT患者切除术后癫痫发作的危险因素。
■一项回顾性研究。
■对2010年10月至2023年4月在我们的三个癫痫中心接受切除手术的LEAT患者的回顾性分析,最少随访1年。人口统计,临床特征,神经生理学,和分子神经病理学评估与术后癫痫发作结果的关系在1,2-,5年随访。采用合成少数过采样技术(SMOTE)算法模型来处理数据分布的不平衡。高斯朴素贝叶斯(GNB)算法被创建为根据观察指标对结果进行分类的基础。
■共111例患者纳入队列。最常见的病理为神经节胶质瘤(n=37,33.3%)。1年随访时癫痫发作自由的患者比例为91.0%(101/111),87.5%(77/88)在2年的随访,在5年随访时,79.1%(53/67)。与全切除和超切除相比,部分切除的癫痫发作结果明显较差(p<0.05)。切除后的术中脑电图(ECoG)或术后头皮脑电图(EEG)上的癫痫样放电是影响术后癫痫发作自由的负面因素,2-,或5年随访(p<0.05)。GNB-SMOTE模型的受试者-工作特征曲线值下的面积为0.95(95%CI,0.876-1.000),0.892(95%CI,0.656-0.934),和0.786(95%CI,0.491-0.937)在1-,2-,5年随访,分别。
■部分切除,手术切除后ECoG,术后头皮脑电图是癫痫发作结局不佳的有价值指标。手术切除后ECoG的应用有利于改善癫痫的预后。基于三个医疗中心的数据多样性和完整性,建立了基于GNB算法的多变量相关分析模型。
UNASSIGNED: Low-grade epilepsy-associated brain tumors (LEATs) are found to be the second most common lesion-related epilepsy. Malignant potential of LEATs is very low and the overall survival is good, so the focus of treatment is focused more on seizure outcome rather than oncological prognosis.
UNASSIGNED: This study was conducted to evaluate the risk factors of seizure outcomes after resection in patients with LEATs.
UNASSIGNED: A retrospective study.
UNASSIGNED: A retrospective analysis of patients with LEATs who underwent resective surgery in our three epilepsy centers between October 2010 and April 2023 with a minimum follow-up of 1 year. Demography, clinical characters, neurophysiology, and molecular neuropathology were assessed for association with postoperative seizure outcomes at 1-, 2-, and 5-year follow-up. Synthetic minority oversampling technique (SMOTE) algorithm model was performed to handle the imbalance of data distribution. Gaussian Naïve Bayes (GNB) algorithms were created as a basis for classifying outcomes according to observation indicators.
UNASSIGNED: A total of 111 patients were enrolled in the cohort. The most common pathology was ganglioglioma (n = 37, 33.3%). The percentage of patients with seizure freedom was 91.0% (101/111) at 1-year follow-up, 87.5% (77/88) at 2-year follow-up, and 79.1% (53/67) at 5-year follow-up. Partial resection had a significantly poor seizure outcome compared to total resection and supratotal resection (p < 0.05). The epileptiform discharge on post-resective intraoperative electrocorticography (ECoG) or postoperative scalp electroencephalography (EEG) were negative factors on postoperative seizure freedom at 1-, 2-, or 5-year follow-ups (p < 0.05). The area under the receiver-operating characteristic curve value of the GNB-SMOTE model was 0.95 (95% CI, 0.876-1.000), 0.892 (95% CI, 0.656-0.934), and 0.786 (95% CI, 0.491-0.937) at 1-, 2-, and 5-year follow-up, respectively.
UNASSIGNED: The partial resection, post-resective intraoperative ECoG, and postoperative scalp EEG were valuable indicators of poor seizure outcomes. The utilization of post-resective intraoperative ECoG is beneficial to improve seizure outcomes. Based on the data diversity and completeness of three medical centers, a multivariate correlation analysis model was established based on GNB algorithm.