摘要
目的探讨结直肠癌骨转移患者的临床特征及预后影响因素，为临床防治结直肠癌骨转移提供参考依据。方法对青岛市第三人民医院2007-02-01—2012-02—28收治的96例结直肠癌骨转移患者的临床及随访资料进行回顾性分析，描述结直肠癌骨转移患者的临床特征，同时采用Cox比例风险回归模型分析结直肠癌骨转移患者预后的影响因素。结果96例结直肠癌骨转移患者占同期结直肠癌患者的6．2％（96／1548），其中多发骨转移71例（74．0％），骨转移常见部位为骨盆（49处）、胸椎（34处）、腰椎（31处）和肋骨（27处）；90例（93．8％）结直肠癌骨转移患者合并有其他部位转移，常见的非骨骼转移为肺转移（61例）、肝转移（49例）和腹膜后淋巴结转移（28例）。结直肠癌骨转移患者中位生存期为11．5个月，1、2和3年生存率为分别为44．9％、29．0％和9．4％。单因素分析显示，不同病理类型、肿瘤分期、骨转移类型、合并其他部位转移、癌胚抗原（CEA）水平和骨转移后化疗情况为结直肠癌骨转移患者预后影响因素，P值均〈0．05。多因素Cox回归分析显示，合并转移部位≥2（RR=2．13，95％CI：1．32～3．44）、结直肠癌Ⅳ期（RR=3．02，95％CI：1．75～5．21）、CEA升高（RR=2．67，95％CI：1．51～4．72）和骨转移后无化疗（RR=3．38，95％CI：1．68～6．78）为结直肠癌骨转移患者预后独立危险因素。结论结直肠癌骨转移患者多合并其他部位转移。合并多部位转移、结直肠癌Ⅳ期、CEA升高、转移后无化疗的结直肠癌骨转移患者的预后较差，应采取综合治疗措施，以延长患者的生存期，提高生活质量。
OBJECTIVE To investigate the clinical features and prognoses factors for patients with diagnosed bone metastases from colorectal cancer in order to provide the reference for clinical prevention and treatment of bone metastasis from colorectal cancer. METHODS The clinical and prognostic data of 96 patients with bone metastasis from colorectal cancer in department of Ontology between February 1, 2007 and February 28, 2012 were retrospectively analyzed. The clinical features of patients with bone metastasis from colorectal cancer were described. Cox＇s proportional hazards regres- sion model was used to investigate the influencing factors for bone metastasis in patients with colorectal cancer. RESULTS Totally 96 patients with bone metastasis from colorectal cancer accounted for 6.2~/oo （96/1 548） of patients with colorec tal cancer in the same period, of which 71 patients had multiple bone metastases （74.0%）. The common sites were pelvic bone metastases （49）, thoracic （34）, lumbar spine （31） and ribs （27）. 90 cases （93.8%） combined with other organs metastases and the common organs were lung metastases （61 cases）, liver metastases （49 cases） and retroperitoneal lymph node metastasis （28 cases）. The median survival time of patients with colorectal cancer after bone metastasis was 11.5 months and the survival rate in 1-year, 2-year, 3-year were 44.9% ,29.0% ,9.4% respectively. Univariate analysis showed that the survival rates among patients with bone metastasis from colorectal cancer with different histological type, tumor stage, type of bone metastasis, combined with other organs, CEA levels and chemotherapy were statistically sig- nificant （P＇~0.05）. Multivariate cox regression showed that combined with other organs （RR： 2. 13,95% CI： 1. 32-- 3.44）, colorectal cancer stage IV （RR=3.02,95% CI：1.75--5.21）, high CEA （RR--2.67,95% CI：1.51--4.72） and no chemotherapy （RR： 3.38,95 %CI 1. 68--6.78） after bone metastasis were risk prognostic factors for patients with bone metastasis from colorectal cancer. CONCLUSIONS Patients with bone metastasis from colorectal cancer often combinewith other organs metastasis. The patients with other organs metastasis, or late stage disease, or high CEA or no chemo- therapy have poor prognosis. Comprehensive measures should be taken to prolong survival time and improve quality of life in patients.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第19期1548-1551,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
结直肠癌
骨转移
临床特征
预后影响因素
回顾性分析
colorectal neoplasms
bone metastasis
clinical features
prognostic factors
retrospective analysis
