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目的:总结非小细胞肺癌骨转移的临床特点,探讨影响其预后的相关因素。方法:总结1999年4月-2006年6月上海市胸科医院住院治疗的174例非小细胞肺癌骨转移患者的临床资料,Kaplan-Meier法估计患者1、2年生存率,单因素分析(Log-rank检验)筛选患者预后的影响因素,多因素分析(COX逐步回归模型)进一步确认独立危险因素。结果:非小细胞肺癌骨转移好发部位依次为胸部(38.1%)、脊柱(32.8%)、骨盆(16.3%)、四肢(8.7%)和颅骨(4.1%),其中肋骨(30.7%)、腰椎(17.3%)、胸椎(13.1%)分列前3位。中位生存时间为10.73个月,Kaplan-Meier生存分析结果显示1年、2年生存率分别为47.1%、17.8%。单因素分析显示:PS评分、骨痛、单纯骨转移、单发骨转移、血清碱性磷酸酶(AKP)、血清乳酸酶(LDH)、CEA水平与预后相关(P<0.05);多因素分析显示:PS评分、单纯骨转移、单发骨转移为非小细胞肺癌骨转移预后的独立影响因素。结论:非小细胞肺癌骨转移好发于胸部(肋骨)、脊柱(腰椎/胸椎)、骨盆(髂骨)等;PS评分、单纯骨转移、单发骨转移可能对患者预后影响较大。
OBJECTIVE: To summarize the clinical features of bone metastasis in non-small cell lung cancer and to explore the related factors that influence its prognosis. Methods: The clinical data of 174 patients with non-small cell lung cancer with bone metastasis admitted from April 1999 to June 2006 in Shanghai Chest Hospital were analyzed. Kaplan-Meier method was used to estimate the 1-year and 2-year survival rates of patients and univariate analysis Log-rank test) screening prognostic factors, multivariate analysis (COX stepwise regression model) to further confirm the independent risk factors. Results: The incidence of bone metastases in non-small cell lung cancer was chest (38.1%), spine (32.8%), pelvis (16.3%), limbs (8.7%) and skull (4.1% Lumbar vertebrae (17.3%), thoracic vertebrae (13.1%) divided into the first three. The median survival time was 10.73 months. Kaplan-Meier survival analysis showed that the 1-year and 2-year survival rates were 47.1% and 17.8% respectively. Univariate analysis showed that PS score, bone pain, simple bone metastasis, single bone metastasis, serum alkaline phosphatase (AKP), serum lactase (LDH) and CEA were correlated with prognosis (P < Show: PS score, simple bone metastases, single bone metastasis of non-small cell lung cancer prognosis of bone independent prognostic factors. CONCLUSION: Bone metastasis of non-small cell lung cancer occurs in the thorax (rib), spine (lumbar / thoracic), pelvis (ilium), etc. PS score, simple bone metastasis and single bone metastasis may have a great impact on the prognosis of patients.