骨髓转移癌28例临床分析  

Clinical analysis of 28 cases with metastatic carcinoma of bone marrow

作　　者：李远发[1] 訚亚涛[1] 竹梦[1] 杜丽蓓[1] 邓春地[1] 曾庆斌[2] 张克俭[2] 

机构地区：[1]武汉大学第二临床学院,武汉430070 [2]武汉大学中南医院血液科

出　　处：《临床血液学杂志》2011年第2期155-157,共3页Journal of Clinical Hematology

摘　　要：目的:探讨骨髓转移癌的常见病因、临床特点及治疗方法。方法:回顾性研究经骨穿明确诊断的病例。结果:28例患者符合纳入标准。明确找到原发灶19例(67.9%),不明病灶9例(32.1%)。骨痛17例(60.7%);贫血12例(42.9%);出血患者9例;碱性磷酸酶升高者14例(50%)。6例行放化疗或者手术干预,其中2例经化疗或者放疗骨痛改善。结论:骨髓转移癌的原发病灶常见于胃癌、前列腺癌、肺癌、卵巢癌;骨痛并贫血、出血和碱性磷酸酶升高患者需警惕骨髓转移癌的存在;原发灶部位明确的患者早期根据部位治疗可延长存活时间,未明病灶有条件者可试用病变局部小剂量放疗或化疗,对缓解症状及延长生存期可能有一定帮助。Objective：To investigate the common pathogenies,clinical features and treatments of metastatic carcinoma of bone marrow.Method：We retrospectively studied the cases which were diagnosed definitely by the bone marrow puncture.Result：A total of twenty-eight cases with metastatic carcinoma of bone marrow were collected.In nineteen patients（67.9%） primary carcinomas were found definitely,but in the other nine patients（32.1%） primary carcinomas were unknown.Seventeen patients（66.6%） had ostalgia.Twelve patients（42.9%） had anemia.Nine patiens had haemorrhagia.Alkaline phosphatase raised in 14 cases（50%）.Six patients were treated by radiotherapy and chemotherapy,or operative intervention.Symptoms of two patients with ostalgia improved after radiotherapy or chemotherapy.Conclusion：The primary sites for metastatic carcinoma of bone marrow is gastric cancer,prostate cancer,lung cancer and ovarian cancer in common.Metastatic carcinoma of bone marrow should be considered when the following features are present： ostalgia,anemia,haemorrhagia and elevation of alkaline phosphatase.In patients with defined primary site,the survival time can be prolonged by treating primary carcinoma.However in patients with unknown origin,the survival may be improved by small dose of radiotherapy regimens combined with chemotherapy regimen.

关 键 词：骨髓转移肿瘤 原发灶 骨痛 治疗 

分 类 号：R733.04[医药卫生—肿瘤]