胃癌骨髓转移的血液学特征和治疗方式探讨  

Hematological characteristics and treatment strategy of bone marrow metastasis in gastric cancer

作　　者：车轶群[1] 罗扬[2] 王迪[1] 沈迪[1] 王爽[3] 杨琳[4] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院检验科,北京100021 [2]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021 [3]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021 [4]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院病理科,北京100021

出　　处：《癌症进展》2017年第6期705-708,共4页Oncology Progress

基　　金：北京市自然科学基金(7162164);首都卫生发展科研专项(首发2014-4-4028)

摘　　要：目的探讨胃癌骨髓转移患者的临床病理特征、治疗及预后。方法回顾性分析9例胃癌骨髓转移患者的临床资料,总结其临床特点、诊断和治疗方法。结果 9例患者的年龄为18~68岁,中位年龄为51岁,病理均为低分化腺癌。患者均伴有其他部位转移,常见淋巴结和骨转移。骨痛、非感染性发热、红细胞和血小板二系下降、碱性磷酸酶和(或)乳酸脱氢酶不同程度升高、外周血涂片可见幼稚细胞是胃癌骨髓转移的常见表现。胃癌骨髓转移患者的中位生存期为34 d(11~266 d)。结论胃癌骨髓转移患者的预后差,熟悉胃癌骨髓转移的临床特点有利于早期诊断。Objective To investigate the clinicopathologic feature, treatment strategies and prognosis of gastric cancer patients with bone marrow metastasis. Method The clinical profile of 9 gastric cancer patients with bone marrow metastasis were analyzed retrospectively. The clinicopathological characteristics, diagnosis and treatment methods were summarized. Result The age of the 9 patients was 18-68（median： 51） and the histological types of all cases were poorly differentiated adenocarcinoma. Disseminated organ metastases were observed in all cases, and most were in distant lymph nodes and bone. Common clinical manifestations of bone marrow metastasis were bone pain, non-infective fever, decrease of 2 indexes in hemogram, increase of alkaline phosphatase and lactate dehydrogenase, immature cells in peripheral blood smears. The median overall survival time of the patients was 34 days（11-266 days）. Conclusion The prognosis of gastric cancer patients with bone marrow metastasis was poor. An in-depth understanding of the clinical features of these rare metastases may help discover the metastasis in the early stage.

关 键 词：骨髓转移 胃癌 治疗 预后 

分 类 号：R738.1[医药卫生—肿瘤]