非小细胞肺癌骨转移的临床与预后分析  

Clinical and prognostic analysis of bone metastases of non-small-cell lung cancer

作　　者：沈玉萍[1,2] 韩宝惠[1] 许青[2] 王慧敏[1] 邱慧敏[2] 顾爱琴[1] 

机构地区：[1]上海交通大学附属上海市胸科医院肺内科,上海200030 [2]同济大学附属上海市第十人民医院肿瘤科,上海200072

出　　处：《第二军医大学学报》2009年第9期1043-1047,共5页Academic Journal of Second Military Medical University

摘　　要：目的:总结非小细胞肺癌骨转移的临床特点,探讨影响其预后的相关因素。方法:总结1999年4月-2006年6月上海市胸科医院住院治疗的174例非小细胞肺癌骨转移患者的临床资料,Kaplan-Meier法估计患者1、2年生存率,单因素分析(Log-rank检验)筛选患者预后的影响因素,多因素分析(COX逐步回归模型)进一步确认独立危险因素。结果:非小细胞肺癌骨转移好发部位依次为胸部(38.1%)、脊柱(32.8%)、骨盆(16.3%)、四肢(8.7%)和颅骨(4.1%),其中肋骨(30.7%)、腰椎(17.3%)、胸椎(13.1%)分列前3位。中位生存时间为10.73个月,Kaplan-Meier生存分析结果显示1年、2年生存率分别为47.1%、17.8%。单因素分析显示:PS评分、骨痛、单纯骨转移、单发骨转移、血清碱性磷酸酶(AKP)、血清乳酸酶(LDH)、CEA水平与预后相关(P<0.05);多因素分析显示:PS评分、单纯骨转移、单发骨转移为非小细胞肺癌骨转移预后的独立影响因素。结论:非小细胞肺癌骨转移好发于胸部(肋骨)、脊柱(腰椎/胸椎)、骨盆(髂骨)等;PS评分、单纯骨转移、单发骨转移可能对患者预后影响较大。Objective：To study the clinical features and prognostic factors of bone metastases of non-small-cell lung cancer.Methods：The clinical data of 174 patients with bone metastases of non-small-cell lung cancer,who were treated in our hospital during April 1999 to June 2006,were retrospectively analyzed.Kaplan-Meier analysis was used to estimate the 1-and 2-year survival rates of patients.Log-rank test was used to screen the factors influencing the survival of patients and Cox regression was used to further confirm the independent factors. Results： The predilection sites of bone metastases of non-small-cell lung cancer were chest （38.1%）,spine （32.8%）,pelvis （16.3%） ,extremities （8.7%）,and skull （4.1%）,with the ribs （30.7%）,lumber vertebrae （17.3%）,and thoracic vertebra （13. 1%） ranking the top three. The median survival time of the 174 patients was 10.73 months; Kaplan-Meier analysis showed that the 1- and 2 year survival rates were 47. 1% and 17.8% ,respectively. It was also showed that the PS Score, bone pain, asymptomatie bone metastases, solitary bone metastasis, serum AKP, LDH, and CEA were associated with the prognosis of patients （P〈0.05）. Multivariate analysis showed that PS score, solitary bone metastasis and single bone metastasis were the independent factors of prognosis. Conclusion.. The predilection sites of bone metastasis of non-small cell lung cancer include chest part （ ribs）, spine （ lumber/thoracic vertebrae）, pelvis （ ilium）, etc. PS score, asymptomatic bone metastases,and solitary bone metastasis have great influence on the prognoses of patients.

关 键 词：骨转移 非小细胞肺癌 骨相关事件 

分 类 号：R734.2[医药卫生—肿瘤]