Analyses of the clinical characteristics of 408 malignant tumor cases with bone metastasis
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摘要:
目的 随着抗肿瘤治疗方法的不断进步, 延长了晚期肿瘤患者的生存期, 出现骨转移及骨相关事件的发生率也随之增加, 本文旨在总结分析转移性骨肿瘤的临床特点, 以期进一步提高早期诊断和治疗水平。 方法 回顾性分析2004年5月至2011年4月本院收治转移性骨肿瘤408例, 总结其病史、原发肿瘤来源、好发部位及转移时间等临床特点。 结果 408例转移性骨肿瘤中, 发病年龄最早的是乳腺癌(57.68岁), 最晚是前列腺癌(72.33岁); 原发肿瘤来源依次为肺癌55.88%(228/408)、乳腺癌8.58%(35/408)、食管癌4.66%(19/408)、肾癌4.41%(18/408)、来源不明4.41%(18/408)、肝癌2.94%(12/408)等; 脊柱受累占74.02%(302/408), 肋骨61.27%(250/408), 骨盆38.24%(156/408), 股骨23.53%(96/408), 胸骨15.44%(63/408);平均转移时间为11.41个月, 最短和最长的分别为胰腺癌(3.0个月)和乳腺癌(55.46个月); 276例骨转移患者在初诊时既已发现骨转移; 228例肺癌骨转移中, 腺癌占39.91%(91/228), 鳞癌占24.56%(56/228), 小细胞癌占5.26%(12/228), 腺鳞癌占3.07%(7/228), 大细胞癌占0.88%(2/228), 病理类型不明为26.32%(60/228);全组中位生存期为18.45个月, 6、12和24个月生存率分别为61.27%、27.70%和10.29%。 结论 转移性骨肿瘤好发于41岁以上患者; 肺癌、乳腺癌、食管癌、肾癌最常发生骨转移, 骨转移常见部位依次为脊柱、肋骨、骨盆、股骨、胸骨, 脊柱中胸椎最常见; 男性骨转移以肺癌、肾癌及肝癌为主, 女性以肺癌、乳腺癌癌和食管癌为主; 肺癌骨转移中腺癌最多见; 积极综合治疗, 可改善骨转移患者症状。 Abstract:Objective The progress of anticancer therapy has facilitated the extension of the survival time of advanced tumor patients. However, the incidence of bone metastases and skeletal-related events(SREs) has also increased. This study aimes to analyze the clinical features of metastatic bone tumors for the further improvement of the early diagnosis and treatment of the disease. Methods Clinical data on 408 patients with metastatic bone tumors admitted to Xi'an Chang An Hospital between 2004 and 2011 were reviewed to summarize the medical history, primary tumor, predilection sites, and time of metastasis of the cases. Results Of the 408 patients with bone metastasis, the youngest age of onset occurred in the breast cases(57.68 years), whereas the eldest occurred in the prostate cases(72.33 years). The proportion of the origin of primary tumors was in the following order: lung cancer(55.88%, 228/408), breast cancer(8.58%, 35/408), esophageal cancer(4.66%, 9/408), renal cancer(4.41%, 18/408), liver cancer(2.94%, 12/408), and unknown sites(4.41%, 18/408). The most common metastatic sites were the spine(74.02%, 302/408), ribs(61.27%, 250/408), pelvis(38.24%, 156/408), femur(23.53%, 96/408), and sternum(15.44%, 63/408). The mean time of metastasis was 11.41 months, whereas the shortest and longest times of metastasis occurred in pancreatic cancer(3 months) and breast cancer(55.46 months), respectively. Bone metastasis was found in 276 patients at initial diagnosis. Among the 228 patients with metastatic lung cancer, adenocarcinoma accounted for 39.91%(91/228), squamous cell carcinoma for 24.56%(56/228), small cell carcinoma for 5.26%(12/228), adenosquamous carcinoma for 3.07%(7/228), large cell carcinoma for 0.88%(2/228), and unknown types for 26.32%(60/228). The median survival time was 18.45 months for all 408 patients, and the six-month, the one-year, and two-year survival rates were 61.27%, 27.70%, and 10.29%, respectively. Conclusion Metastatic bone tumors occur the most frequently in patients over 41 years.The most commonly sites of origin include the lungs, breast, esophagus, and kidney. The predilection sites of bone metastases are the spine, ribs, pelvis, femur, and sternum. The thoracic spine is the most common site of vertebral metastases. Lung cancer, renal cancer, and liver cancer are the main cancer types in male patients, whereas the main cancer types for female patients are breast cancer and esophageal cancer. Adenocarcinoma is most commonly found in cases with bone metastases of lung cancer. Comprehensive treatment can significantly control symptoms and can prevent SREs. -
Key words:
- secondary bone neoplasms /
- clinical features /
- retrospective analysis
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表 1 408例转移性骨肿瘤转移部位分布情况
Table 1. Distribution of tumor metastases in 408 cases with metastasized bone tumors
表 2 228例肺癌骨转移患者病理类型分布
Table 2. Disatribution of pathological types in 228 lung cancer cases with bone metastasis
表 3 228例肺癌平均转移时间
月 Table 3. Mean time of metastasis in 228 lung cancer cases
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