脊柱肿瘤患者流行病学及术后生存状况分析  

Epidemiology and survival analysis in patients with spinal tumor after surgery

作　　者：郑伟[1] 吴娟[2] 杨立利[1] 郭强[3] 胡晓媛[3] 肖建如[1] 

机构地区：[1]第二军医大学长征医院骨科,上海200003 [2]成都军区总医院药剂科,成都610083 [3]第二军医大学训练部,上海200003

出　　处：《中国矫形外科杂志》2011年第19期1649-1653,共5页Orthopedic Journal of China

摘　　要：[目的]总结分析2000年1月～2007年1月于上海长征医院脊柱外科行手术治疗的原发或转移性脊柱肿瘤患者流行病学特征和术后生存状况。[方法]选取所有符合条件患者的病历及随访资料作为研究对象。收集的资料包括性别、年龄、肿瘤类型/原发肿瘤类型、肿瘤部位、术后生存时间。分为原发脊柱肿瘤和转移性脊柱肿瘤两组。[结果]入选371例患者,其中原发组170例(45.8%),转移组201例(54.2%)。原发脊柱肿瘤组中,男性101例(59.4%),女性69例(40.6%);年龄范围(10～81)岁,平均年龄(43.6±16.5)岁。转移性脊柱肿瘤组中,男性126例(62.7%),女性75例(37.3%);年龄范围21～87岁,平均年龄(53.6±10.5)岁。原发组中骨巨细胞瘤和脊索瘤最多,各35例,各占20.6%。转移组患者中肺癌、肝癌和甲状腺癌例数占前三位,分别为66例(32.8%)、42例(20.9%)、23例(11.4%)。两组患者肿瘤侵犯部位及频率大体相近,但原发组肿瘤侵犯骶骨和寰枢椎的较转移组多。截止到2010年6月30日,原发组最短术后生存时间为14个月,最长为121个月,中位生存时间为71.7个月,5年期生存率为50%;转移组最短生存时间为3个月,最长生存时间为67个月,中位生存时间为28.4个月,3年期生存率为37%。[结论]两组患者的年龄差异有统计学意义,原发脊柱肿瘤组患者的年龄分布更广,且平均年龄更小。原发组患者术后生存时间远长于转移性组患者。手术治疗原发性脊柱肿瘤效果显著。对于转移性脊柱肿瘤患者来说,外科手术是一种对症的姑息治疗,延长转移癌患者的生存时间、改善其生命质量的关键在于针对原发肿瘤的综合治疗。[Objective]To analyze the epidemiology and survival in patients with spinal tumor after surgery from January 2000 to January 2007 in Changzheng Hospital. [Methods]All eligible patients were separated into two groups depending on whether they were primary spinal tumors or spinal metastases.Data were collected including gender,age,tumor type,tumor position,and survival. [Results]We identified 371 patients（primary spinal tumor group,n=170,spinal metastasis group,n=201） who were eligible for the study from Changzheng Hospital,the Second Military Medical University in Shanghai,China.In primary spinal tumor group,the mean age was 43.6±16.5 years（range,10～81）,and male/female ratio was 1.46：1.In spinal metastasis group,the mean age was 53.6±10.5 years（range,21～87）,and male/female ratio was 1.68：1.The first two types of tumor in primary spinal tumor group were giant cell tumor（35 patients,20.6%）,and chordoma（35 patients,20.6%）.The first three types of primary tumor in metastasis group were lung（66 patients,32.8%）,liver（42 patients,20.9%）,and thyroid（23 patients,11.4%） cancer,respectively.Whether in the primary group or in the metastasis group,tumor could attack any segment of the spine.At the end of the study（June 30,2010）,the median survival time was 71.7 months（range,14-121 months） in primary spinal tumor group and 28.4 months（range,3-67 months） in spinal metastasis group. [Conclusion]There were no statistically significant differences between the two groups in gender,but not in age and survival.In primary spinal tumor group,the range of patient age was wider,and the mean age was younger than that in the metastasis group.Patients with primary spinal tumors survived longer than patients with spinal metastases after surgery.They could gain more benefit from the spinal surgery.Treatments for patients with spinal metastases mainly focus on two aspects： the nature of primary tumor and the spinal metastatic lesions.Both comprehensive therapy and local treatment are cruci

关 键 词：脊柱肿瘤 流行病学 生存状况分析 原发脊柱肿瘤 转移性脊柱肿瘤 

分 类 号：R738.1[医药卫生—肿瘤]