以风湿样症状为首发的恶性肿瘤、肿瘤复发或转移26例临床分析

Rheumatic symptoms associated with malignancies,relapse or metastasis:a report of 26 cases

目的提高对以风湿样症状为首发的恶性肿瘤、肿瘤复发或转移的认识。方法回顾性分析住院患者中以风湿样症状为首发,最后确诊为恶性肿瘤、肿瘤复发或转移的26例临床资料。结果以风湿样症状为首发而确诊为恶性肿瘤者19例,肿瘤转移或复发者7例,大部分患者年龄均超过50岁;起病时血沉均明显增快,其中约70%超过100 mm/h;所有患者均对非甾体类抗炎药(NSAIDs)、激素治疗效果不好。结论应重视以风湿样症状为首发的恶性肿瘤、肿瘤复发或转移的诊断,尤其是对老年、难以解释的血沉极度增快、以及对NSAIDs、激素治疗无效的患者。

Objective To improve the understanding of rheumatic symptoms associated with malignancies, relapse or metastasis. Methods All in-patients from Jun. 1997 to Sep. 2006 in our department were investigated retrospectively. Result There was 26 cases of rheumatic symptoms associated with malignancies, relapse or metas- tasis. The age of the majority of these patients was 50 years or older. The percentage of extreme elevation erythrocyte sedimentation rate （ESR） was about 70%. All of these patients were poor response to the treatment of non-steroidal anti-rheumatic drugs （NSAIDs） and glucocorticoid. Conclusion We should pay more attention to the diagnosis of rheumatic symptoms associated with malignancies, relapse or metastasis ,especially to patients more than 50 years old who had unexplained extreme elevation of the ESR, and inefficacy of NSAIDs and glucocorticoid.