不明原发灶骨转移癌的诊疗进展  

Research progress of bone metastases from cancer of unknown primary

作　　者：王达[1] 胡劲博 刘玉杰[1] 何韶辉 龚海熠 张浩[1] 肖建如[1] 

机构地区：[1]第二军医大学附属长征医院骨肿瘤科,上海200003

出　　处：《中国骨与关节杂志》2017年第9期716-720,共5页Chinese Journal of Bone and Joint

摘　　要：不明原发灶转移癌（cancer of unknown primary,CUP）是一类独立的转移性肿瘤的统称,组织学确诊为转移癌但检查后不能明确其原发解剖部位,约占人类所有新发癌症的3%-5%,是人类第7-8位常见的恶性肿瘤,也是第4位常见的致死性癌症。骨是CUP的第3好发部位,不明原发灶骨转移癌（bone metastases from cancer of unknown primary,BMCUP）是CUP中一种整体预后很差的类型,明确肿瘤的原发部位,Objective Bone metastasis from cancer of unknown primary （ BMCUP ） is one of the most common types among cancers of unknown primary （ CUP ）, which is a heterogeneous group of cancers, and the anatomical site of origin remains occult after detailed investigations of medical history, physical examinations and related laboratory tests. Due to its insidious onset, non-specific symptoms, high risk of involving multiple organs as well as poor prognosis, early diagnosis is rather difficult. This article will make a brief review of related literatures and aim at presenting current diagnostic and therapeutic strategies of BMCUE Methods By using key words such as bone metastases, cancer of unknown primary, immunohistochemistry, molecular diagnosis and targeted therapy, we searched databases including Pubmed, EMBASE, Web of Science and CNKI. Results Lung cancer was the main causative occult primary for bone metastases and had a poor prognosis with an average survival of 3 months. Diagnostic approaches to identify the primary sites included clinical evaluation, detailed radiological assessment and histopathological examination. The main purpose of current diagnosis was to identify the primary sites of BMCUP and make a classification according to their prognosis. Clinical protocols focused on direct and effective treatment of subtypes with good prognosis, as well as long-term and effective control of subtypes with poor prognosis. With the rapid development of molecular biology and genomics, molecular diagnosis may be the cornerstone of the future treatment of BMCUP. Conelusions Compared to treatment for bone metastases of known origin, standard treatment for BMCUP is still controversial. In the era of tailored therapeutic strategies, this situation presents both an opportunity and a challenge.

关 键 词：骨肿瘤 肿瘤转移 肿瘤 未知原发灶 诊断 临床方案 综述 

分 类 号：R738.1[医药卫生—肿瘤]