小细胞肺癌椎管内转移患者不同部位的临床特征及预后  

Clinical Features and Prognosis of Different Sites of Small Cell Lung Cancer with Intraspinal Metastasis

作　　者：王宜宗[1] WANG Yizong(Rizhao hospital of traditional Chinese medicine,Rizhao,Shandong 276800)

机构地区：[1]日照市中医医院,山东日照276800

出　　处：《中国伤残医学》2024年第9期64-67,71,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨小细胞肺癌椎管内转移患者不同部位的临床特征及预后。方法:选取2017年1月-2021年1月我院收治的6例小细胞肺癌椎管内转移患者为研究对象,根据椎管内转移的部位以第一腰椎椎体(L_(1))为界,将其分为2组。观察2组临床症状至截瘫发生时间、总生存时间。结果:4例患者发展为截瘫,其转移部位均位于脊髓胸段。胸段转移患者截瘫的中位时间为7d,L_(1)平以下转移患者未发展为截瘫,差异有统计学意义(P<0.05)。胸段转移患者的中位总生存期为4个月,L_(1)水平以下转移患者的中位总生存期为11个月,差异有统计学意义(P<0.05)。结论:椎管内转移的小细胞肺癌患者的首发症状是对称性感觉麻木、进行性肌力下降和大小便失禁,需高度重视并注意识别。胸段转移患者比L_(1)水平以下转移患者更容易发展为截瘫,胸段转移患者的总生存期缩短。Objective:To investigate the clinical features and prognosis of different sites of small cell lung cancer with intraspinal metastasis.Methods:6 patients with intraspinal metastasis of small cell lung cancer admitted to our hospital from January 2017 to January 2021 were selected as the study objects,and divided into two groups according to the location of intraspinal metastasis of the first lumbar vertebra(Li).The time from clinical symptoms to the occurrence of paraplegia and the overall survival time of the 2 groups were observed.Results:4 of whom developed paraplegia,and the metastatic sites were located in the thoracic segment of the spinal cord.The median time of paraplegia in patients with thoracic segment metastasis was 7 days,and patients with metastasis below L,level did not develop paraplegia,the difference was statistically significant(P<0.05).The median overall survival of patients with thoracic segment metastasis was 4 months,and the median overall survival of patients with metastasis below L,level was 11 months,with statistical significance(P<0.05).Conclusion:The first symptoms of patients with intraspinal metastasis of small cell lung cancer are symmetrical numbness,progressive muscle strength loss,and urinary and bowel incontinence,which should be highly valued and recognized.Patients with thoracic metastases are more likely to develop paraplegia than those with metastases below L1 level,and overall survival is shortened in patients with thoracic metastases.

关 键 词：小细胞肺癌 椎管内转移 截瘫 

分 类 号：R734.2[医药卫生—肿瘤]