结直肠癌骨转移的诊治现状和进展  

Progress in the diagnosis and treatment of bone metastasis in colorectal cancer

作　　者：洪若熙[1] 罗健[1] 

机构地区：[1]北京协和医学院.中国医学科学院肿瘤医院内科,北京100021

出　　处：《中华肿瘤防治杂志》2013年第20期1619-1622,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:回顾和总结国内外结直肠癌骨转移流行病学、诊断和治疗的研究现状和进展。方法:应用Pubmed和CNKI期刊全文数据库检索系统,以"结直肠癌/大肠癌、骨转移、双磷酸盐、诊断和治疗"作为关键词,检索1991-01-2013-02相关文献。纳入标准:1)结直肠癌骨转移的流行病学及临床特点;2)结直肠癌骨转移的诊断和治疗进展。根据纳入标准符合分析的文献37篇。结果:文献报道的结直肠癌骨转移发病率为6%～10.4%。结直肠癌骨转移最常见于椎骨,其次为骨盆及肋骨。结直肠癌骨转移常合并其他脏器转移,如肝、肺。骨相关事件(SRE)发生率约为70%。文献报道首次发生SRE后的中位生存时间为4.5个月。结直肠癌骨转移的诊断主要依靠X射线、CT、MRI、PET/CT等影像学检查。治疗目的以姑息为主,双磷酸盐治疗及局部放疗占有重要地位。结论:结直肠癌骨转移的发病率呈上升趋势。在结直肠癌患者的管理中应警惕骨转移可能,争取早诊早治。应根据患者情况选择治疗方法,必要时联合几种治疗方法。OBJECTIVE：To review the progress in the epidemiology,diagnosis and treatment of bone metastasis in colorectal cancer. METHODS： Use ＂colorectal cancer＂, ＂bone metastasis＂, ＂bisphosphonates＂, ＂diagnosis＂ and ＂treatment＂ as key words land search for literature published between January 1991 to February 2013 in Pubmed and CNKI data-bases. Choice criteria： 1） epidemiology and clinical characteristics of colorectal cancer; 2） recent progress in the diagnosis and treatment of bone metastasis in colorectal cancer. A total of 37 articles were included. RESULTS： The overall incidence of bone metastasis from CRC has been reported from 6% to 10.4%. The most commonly involved bone lesions include verte bra, pelvis and ribs. Bone metastasis from CRC is usually concurrent with other organ invlovement, such as liver and lung. The most serious consequence is skeletal related events （SREs）,which occur in approximately 70% of the patients with this disease. The median survival time after the first SRE was reported to be 4.5 months. The diagnosis of bone metastasis from CRC is mainly based on the imaging studies, including X ray,CT,MRI and PET/CT. Use of bisphosphonates and ra diotherapy plays an important role in the palliative setting. CONCLUSIONS： The incidence of bone metastasis from color enctal cancer is uprising. In managing advanced colorectal cancer patients, clinicians should be aware of the potential for bone metastasis. Early treatment may improve outcomes of bone metastasis.

关 键 词：结直肠肿瘤 骨转移 临床特点 诊断 姑息治疗 综述文献 

分 类 号：R735.3[医药卫生—肿瘤]