胃癌骨转移的临床特征及主要预后因素分析  

Clinical Features and Prognostic Factors of Patients with Bone Metastases from Stomach Cancer

作　　者：何健[1] 曾昭冲[1] 杨平[1] 孙菁[1] 杜世锁[1] 姜威[1] 

机构地区：[1]复旦大学附属中山医院放疗科,上海200032

出　　处：《中国临床医学》2011年第1期69-71,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨胃腺癌(下称胃癌)骨转移患者的临床特征及其相关的预后因素。方法:分析1997年—2007年间诊治38例胃癌骨转移患者临床资料。对患者的年龄、性别、原发灶大小、初诊时临床分期、原发灶是否手术及化疗、骨转移灶数目、骨转移时碱性磷酸酶(ALP)水平、癌胚抗原(CEA)水平、是否伴骨旁软组织转移、骨转移时是否伴淋巴结转移和是否伴有其他脏器转移多项因素进行分析,生存率分析应用Kaplan-Meier法,单因素分析采用Log-rank方法,多因素分析采用Cox回归模型。结果:胃癌骨转移患者的生存率,1年为47.1%,2年为29.6%,3年为24.7%,中位生存期5.5个月。单因素分析结果显示骨转移时CEA水平各组间的生存率差异有统计学意义(P<0.05),其余各项因素的组间差异均无统计学意义。Cox模型多因素分析提示骨转移时ALP水平是影响预后的因子。结论:胃癌患者出现骨转移后其生存率明显下降,骨转移时ALP水平是影响预后的因子。Objective：To identify clinical features and predictors of survival in patients with bone metastases from stomach cancer.Methods： We retrospectively analyzed 38 patients with bone metastases from stomach cancer between 1997 and 2007.Univariate analysis and multivariate analysis were conducted for the potential factors including age,gender,tumor size,stage,resection of primary tumors,chemotherapy of primary tumors,number of bone lesions,carcino-embryonic antig（CEA）level,alkaline phosphatase（ALP） level,parenchyma metastases of bone-side,lymph node metastases,and other organ metastases.Survival time was calculated by the Kaplan-Meier method.The Cox regression model was used for multivariate analysis.Results： The following-up rate was 100%.The 1-,3-,5-year survival rates and median survival time were 47.1%,29.6%,24.7% and 5.5 months for patients with bone metastases from stomach cancer,respectively.By univariate analysis,CEA level was a prognostic factor.ALP level was independent prognostic factors in multivariate analysis.Conclusions： The survival rate was lower in patients of stomach cancer with bone metastases than without.ALT level was independent prognostic factors.

关 键 词：胃癌 转移 骨 预后因素 

分 类 号：R735.2[医药卫生—肿瘤]