发生骨相关事件的股骨转移瘤临床特点分析  

Clinical analysis of fracture related femoral metastatic tumors

作　　者：孙涛[1] 郭昶志 齐典文[1] 胡彤宇[1] 赵茗[1] 周庄[1] 扈文海[1] 张国川[1] 

机构地区：[1]河北医科大学第三医院骨与软组织肿瘤科,石家庄050051

出　　处：《中华老年骨科与康复电子杂志》2017年第3期136-142,共7页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：河北省卫生与计划生育委员会老年病项目(2014-2016)

摘　　要：目的探讨股骨转移瘤流行病学特征。方法回顾性分析2010年1月至2015年12月河北医科大学第三医院、济南军区总医院和齐鲁医院诊治的股骨转移瘤患者160例,按股骨转移部位分为三组:股骨近端组、股骨干组和股骨远端组,比较各组患者的性别、年龄、肿瘤原发部位、转移部位、病理性骨折以及治疗方法等方面的差异。结果共纳入121例股骨转移瘤患者,男性72例,女性49例,中位年龄58岁(22~87岁),其中50~69岁患者居多。原发肿瘤来源前三位依次为肺(49.6%)、肾(14.9%)和未知来源肿瘤(12.4%)。发生病理性骨折33例(27.3%),诊断明确后保守治疗35例(28.9%),活检后选择保守21例(17.4%),手术治疗65例(53.7%)。股骨近端组77例(63.6%)、股骨干组33例(27.3%)、股骨远端组11例(9.1%)。股骨干组发生病理性骨折比例最高(42.4%),股骨近端组次之(23.4%),股骨远端组最低(9.1%),差异有统计学意义(x^2=6.242,P<0.05)。股骨远端组囊内切除比例最高(71.4%),股骨干组次之(55.0%),股骨近端组最低(23.7%),差异有统计学意义(x^2=9.031,P<0.05)。股骨近端组关节置换重建比例最高(75.7%),股骨远端组次之(33.3%),股骨干组最低(25.0%),差异有统计学意义(c^2=30.223,P<0.001)。三组患者性别、年龄、治疗方式及原发肿瘤类型分布无统计学差异(P>0.05)。结论股骨转移瘤导致病理性骨折发生率较高,大多应手术治疗。股骨近端转移瘤以关节置换为主,骨干和远端以骨水泥内固定为主。Objective To analyze the epidemiology of femoral metastatic tumors. Methods A retrospective study was performed in 121 patients with femoral metastatic tumors treated in Third Hospital of Hebei Medical University, The General Hospital of Jinan Military Commanding Region, Qilu Hospital between January 2010 and December 2015. Patients were divided into proximal Group, shaft Group, and distal Group according to metastatic site of femur. The gender, age, original tumor site, femoral metastatic site, pathological fracture, treatment method and et al were collected and compared among groups. Results A total of 121 cases were included in this study （72 male and 49 female） with median age of 58 years, dominant age were 50 to 69 years. The common metastatic tumors origin from lung tumor （49.6%）, kidney tumor （14.9%）, and unknown tumors （12.4%）. 33 cases （27.3%） sustained pathological fractures. Thirty-five cases （28.9%） refused surgery, 21 cases （17.4%） refused further surgery after biopsy, and 65 cases （53.7%） received final surgery. 77 cases were included in proximal Group （63.6%）, 33 cases in shaft Group （27.3%）, and 11 cases in distal Group （9.1%）. Shaft Group （42.4%） had the highest incidence of pathological fracture, proximal Group was 23.4% and distal Group was 9.1%, differences were statistically significant （χ^2=6.242, P〈0.05）. The highest incidence of intralesional resection was in distal Group （71.4% ）, followed by shaft Group （55.0%） and proximal Group （23.7%）, differences were statistically significant （χ^2=9.031, P〈0.05）. Prosthesis reconstruction was common in proximal Group （75.7%）, followed by distal Group （33.3%） and shaft Group （25.0% ）, differences were statistically significant （χ^2=30.223, P〈0.001）. There were no differences on sex, age, primary tumor types and treatment method between three groups （P〉0.05）. Conclusion The incidence of pathological fractures due to metastatic tumor is very high, most of

关 键 词：股骨 肿瘤转移 流行病学 病理性骨折 

分 类 号：R738[医药卫生—肿瘤]