修订Tokuhashi评分在预测脊柱转移瘤患者临床预后及治疗方式选择中的价值  

The value of revised Tokuhashi score in predicting the clinical prognosis of patients with spinal metastases and the choice of treatment methods

作　　者：张睿[1] 张意虎 张玉容 童铃 蒋欣廷[1] 彭国霖 ZHANG Rui;ZHANG Yihu;ZHANG Yurong;TONG Ling;JIANG Xinting;PENG Guolin(Department of Orthopedics,the First Peoples'Hospital of Yibin,Sichuan Yibin 644000,China.;Department of Emergency,the First Peoples'Hospital of Yibin,Sichuan Yibin 644000,China)

机构地区：[1]宜宾市第一人民医院骨科,四川宜宾644000 [2]宜宾市第一人民医院急诊科,四川宜宾644000

出　　处：《现代肿瘤医学》2023年第15期2910-2915,共6页Journal of Modern Oncology

基　　金：四川省卫计委科研课题(编号:18PJ572)。

摘　　要：目的:探讨修订Tokuhashi评分在预测脊柱转移瘤患者临床预后及治疗方式选择中的价值。方法:回顾2010年01月至2020年12月我院骨科收治的脊柱转移瘤住院患者127例,收集病历资料,随访临床结局至2022年06月30日,采用Kaplan-Meier法绘制生存曲线,Log-rankχ^(2)检验和Cox回归分析患者预后的影响因素。结果:患者中位生存时间为10个月,随访期内死亡占比76.38%,6个月和12个月生存率分别为69.29%和27.56%。修订Tokuhashi评分0~8分、9~11分和≥12分的患者生存时间分别为(6.99±2.54)个月、(11.44±2.87)个月和(18.56±4.80)个月。不分组和按生存时间≤12个月分组修订Tokuhashi评分预测患者预后的ROC曲线下面积分别为0.960和0.863。Cox回归显示:修订Tokuhashi评分、脊柱外骨转移数量和内脏转移情况是脊柱转移瘤预后的影响因素,修订Tokuhashi分级9~11分、≥12分的HR分别为0.484和0.033(与≤8分比,P<0.05),脊柱外转移瘤数量1~2个和0个的HR分别为0.345和0.064(与≥3个比,P<0.05),内脏转移可切除的HR为0.460(与内脏转移不可切除比,P<0.05)。修订Tokuhashi评分0~8分、9~11分和≥12分的患者6个月生存率分别为45.45%、91.18%和100.00%。结论:脊柱转移瘤患者预后较差,修订Tokuhashi评分系统能预测患者临床结局,对合理选择治疗方式有一定指导意义。Objective:To explore the value of revised Tokuhashi score in predicting the clinical prognosis of patients with spinal metastases and the choice of treatment methods.Methods:From January 2010 to December 2020,127 inpatients with spinal metastasis were reviewed from department of orthopedics in our hospital.The medical records were collected and the clinical outcomes were followed up until June 30,2022.The survival curve was drawn by Kaplan-Meier method.Log-rank Chi-square test and Cox regression analysis were used to analyze the factors affecting the prognosis of patients.Results:The median survival time of the patients was 10 months.The death rate in the follow-up period was 76.38%.The 6-month and 12-month survival rates were 69.29%and 27.56%respectively.The survival time of patients with revised Tokuhashi score of 0~8 points,9~11 points and≥12 points was(6.99±2.54)months,(11.44±2.87)months and(18.56±4.80)months,respectively.The area under the ROC curve for predicting the prognosis of patients with revised Tokuhashi score was 0.960 and 0.863,respectively,without grouping and according to survival time≤12 months.Cox regression showed that the revised Tokuhashi score,the number of extraspinal bone metastasis and visceral metastasis were the influencing factors of the prognosis of spinal metastasis.The HR of the revised Tokuhashi score of 9~11 points and≥12 points were 0.484 and 0.033 respectively(compared with≤8 points,P<0.05),and the HR of the number of extraspinal metastasis of 1~2 sites and 0 site were 0.345 and 0.064 respectively(compared with≥3 sites,P<0.05).The HR of resectable visceral metastasis was 0.460(compared with inresectable visceral metastasis,P<0.05).The 6-month survival rate of patients with revised Tokuhashi score of 0~8 points,9~11 points and≥12 points was 45.45%,91.18%and 100.00%respectively.Conclusion:The prognosis of patients with spinal metastasis is poor.The revised Tokuhashi scoring system can predict the clinical outcome of patients,and has certain guiding significance for

关 键 词：脊柱转移瘤 修订Tokuhashi评分系统 预后 预测 

分 类 号：R738.1[医药卫生—肿瘤]