前列腺癌、乳腺癌及肺癌的脊椎盆腔骨转移与脊椎盆腔之外骨骼转移的关系  

Relation Between Metastases of the Vertebrae or Pelvis and Metastases of Bones Except for the Vertebrae and Pelvis in Prostate,Breast and Lung Cancers

作　　者：沈美娟[1] 汪长银[1] 田月丽[1] 李崇佼 沈影[1] 何勇 SHEN Meijuan;WANG Changyin;TIAN Yueli(Zhongnan Hospital of Wuhan University,Wuhan,430071)

机构地区：[1]武汉大学中南医院,430071

出　　处：《实用癌症杂志》2018年第5期835-839,共5页The Practical Journal of Cancer

摘　　要：目的研究肿瘤患者脊椎盆腔骨转移与脊椎盆腔之外骨骼转移的关系,探讨前列腺癌、乳腺癌与肺癌的骨转移规律。方法收集执行了核素骨显像检查且病理学确诊了原发病灶的前列腺癌、乳腺癌与肺癌骨转移瘤患者的资料。将骨骼分为两大区域:脊椎盆腔骨骼,脊椎与盆腔之外的骨骼,比较前列腺癌、乳腺癌与肺癌两大区域骨转移病灶的特点与相互关系。结果 (1)脊椎、盆腔骨骼未发生转移时,前列腺癌骨转移患者比率[3.9%(4/102)]低于乳腺癌[32.7%(49/150)](χ~2=35.958,P=0.000)与肺癌[24.0%(62/258)](χ~2=24.724,P=0.000)。(2)前列腺癌单纯脊椎或盆腔骨转移患者比率[31.4%(32/102)]高于乳腺癌[18.7%(28/150)](χ~2=5.329,P=0.021)与肺癌[16.7%(43/258)](χ~2=9.065,P=0.003)具有统计学意义。(3)前列腺癌单纯脊椎或盆腔骨骼转移的患者比率[31.4%(32/102)]高于脊椎、盆腔未发生骨转移的患者比率[3.9%(4/102)](χ~2=21.778,P=0.000);乳腺癌单纯脊椎或盆腔骨骼转移的患者比率[18.7%(28/150)]低于脊椎、盆腔未发生骨转移的患者比率[32.7%(49/150)](χ~2=5.727,P=0.022);肺癌单纯脊椎或盆腔骨骼转移的患者比率[16.7%(43/258)]与脊椎、盆腔未发生骨转移的患者比率[24.0%(62/258)]差异无统计学意义(χ~2=3.438,P=0.078)。结论乳腺癌、肺癌既可以早期扩散到脊椎与骨盆,也可以早期播散到脊椎、盆腔之外的骨骼,且比前列腺癌易于早期扩散到脊椎、盆腔之外的骨骼,而前列腺癌则具有首先转移到脊椎或盆腔骨骼而后扩散到脊椎、盆腔之外骨骼的特征。Objective To investigate bone metastasis distribution patterns of prostate,lung and breast cancers by studying the relationship between metastases of the vertebrae or pelvis and metastases of bones except for the vertebrae and pelvis.Methods The data of patients with bone metastases who were confirmed as prostate,lung and breast cancers by pathological methods and performed technetium-99 m methylene diphosphonate bone scan,were collected and analyzed. The skeleton of patients was categorized into two regions：bones of the vertebrae and pelvis,and bones of except for the vertebrae and pelvis. The distribution characteristic of bone metastases and relation between the two regions among prostate,lung and breast cancers were analyzed.Results（1）In groups without the vertebral and pelvic metastasis,3. 9%（4/102） prostate cancer patients were found bony metastases,and the proportion was significantly lower than that 32. 7%（49/150） of breast cancer patients（ χ~2= 35. 958,P = 0. 000）,and that 24. 0%（62/258） of lung cancer patients（ χ~2= 24. 724,P = 0. 000）.（2）In groups only with vertebral or pelvic metastasis,31. 4%,（ 32/102） prostate cancer patients presented bone metastases,the proportion was significantly higher than that18. 7%（28/150） of breast cancer patients（ χ~2= 5. 329,P = 0. 021） and that 16. 7%（43/258） of lung cancer patients（ χ~2=9. 065,P = 0. 003）.（3）In prostate cancer patients,the proportion 31. 4%（32/102） only with the vertebral and pelvic metastasis was significantly higher than that 3. 9%（4/102） without the vertebral and pelvic metastasis（ χ~2= 21. 778,P = 0. 000）;in breast cancer patients,the proportion 18. 7%（ 28/150） only with the vertebral and pelvic metastasis was significantly lower than that 32. 7%（49/150） without the vertebral and pelvic metastasis（ χ~2= 5. 727,P = 0. 022）;in lung cancer patients,the difference between the proportion 16. 7%（43/258） only with the vertebral and pelvic metastasis and that 24. 0%（62

关 键 词：前列腺癌 乳腺癌 肺癌 肿瘤转移 骨转移 骨显像 

分 类 号：R738.1[医药卫生—肿瘤]