鳞癌相关性高钙血症的临床特点及预后因素  

Clinical Characteristics and Prognostic Factors of Malignancy-associated Hypercalcemia in Squamous Cell Carcinoma

作　　者：张素洁[1] 胡毅[1] 焦顺昌[1] 刘哲峰[1] 陶海涛[1] 

机构地区：[1]中国人民解放军总医院肿瘤内科,北京100853

出　　处：《中国医学科学院学报》2012年第6期585-589,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的总结鳞癌相关性高钙血症患者的临床特点及预后因素。方法回顾性分析2001年1月至2010年12月在中国人民解放军总医院肿瘤内科收治的36例鳞癌相关性高钙血症患者的临床资料,随访观察其生存情况,总结其临床特点及影响预后的主要因素。结果 36例患者的中位血钙浓度为2.94 mmol/L(2.77～4.87 mmol/L),发现高钙血症后中位生存时间为45 d(1～839 d)。单因素分析结果显示,精神症状(P=0.003)、骨转移(P=0.049)、确诊肿瘤至出现高钙血症时间>160 d(P=0.005)为不良预后因子。多因素分析结果显示,精神症状(RR=5.721,P=0.000)及确诊肿瘤至出现高钙血症时间>160 d(RR=4.624,P=0.001)是鳞癌相关性高钙血症患者预后的独立危险因素。结论鳞癌相关性高钙血症多见于恶性肿瘤晚期,预后差。精神症状及确诊肿瘤至出现高钙血症时间>160d是预后相关的独立危险因素。Objective To explore the clinical characteristics and prognostic factors of patients diagnosed with squamous cell carcinoma（SCC） and presented malignancy-associated hypercalcemia（MAH）.Methods We retrospectively analyzed the clinical data of 36 patients with biopsy-proven SCC and presented MAH who were treated at the our department from January 2001 to December 2010.The survival were analyzed using the Kaplan-Meier method and Cox analysis.Results Among these 36 patients,the median blood calcium level was 2.94 mmol/L（2.77-4.87 mmol/L）,and the median survival time was only 45 days（1-839 d）.Log-rank test showed that central nervous system symptoms,bone metastasis,and hypercalcemia occurring over 160 days after cancer diagnosis were predictors for poor survival（P=0.003,P=0.049,P=0.005）.In the COX proportional hazard model analysis,central nervous system symptoms and hypercalcemia occurring over 160 days after cancer diagnosis were independent prognostic factors for survival time（RR=5.721,P=0.000;RR=4.624,P=0.001）.Conclusions Patients with squamous cell carcinoma（SCC） and presented MAH have poor prognosis.Central nervous system symptoms and hypercalcemia occurring over 160 days after cancer diagnosis are independent predictors of the prognosis.

关 键 词：高钙血症 鳞癌 预后因素 

分 类 号：R730.4[医药卫生—肿瘤] R730.5[医药卫生—临床医学]