胃癌骨转移相关因素探讨

Correlative factors of skeletal metastases of gastric carcinoma

为探讨胃癌骨转移及其影响因素，对１３１例胃癌患者进行了核素骨显像检查，对骨转移与时间的关系进行了前瞻性研究，对影响骨转移的因素进行了分析。结果：胃癌骨转移的发生率达４１２％，随时间的增加有明显增高的趋势；胃癌骨转移与临床分期（ｒ＝０．９６５）和病理形态学类型（ｒ＝０．９５８）有关（Ｐ均＜０．０５）；与肿瘤的大小（ｒ＝０．７３０）、部位（ｒ＝－０．５１３）和病理组织学类型（ｒ＝－０．６７３）无关（Ｐ均＞０．０５）；临床Ⅲ、Ⅳ期与Ⅰ、Ⅱ期胃癌间（χ２＝１１９９），浸润、扩散型与赘生、溃疡型胃癌间（χ２＝１４．４５）骨转移的发生有显著性差异（Ｐ均＜０．０１）。结果提示：胃癌特别是临床Ⅲ、Ⅳ期和（或）浸润与扩散型患者应常规定期行核素骨显像检查。

? To study the influencing factors for skeletal metastases of gastric carcinoma, 131 patients with gastric carcinoma were examined with nuclear skeletal imaging.Prospective study was made on the relation between bone metastases and time,and the influencing factors of skeletal metastases were statistically analyzed.41.2% patients with gastric carcinoma had skeletal metastases,and an increasing tendency was observed with the time passing by.The skeletal metastases was correlated with the clinical stages(r=0.965,P<0.05) and the pathomorphologic types(r=0.958,P<0.05) but not with the tumor sizes (r=0.730,P>0.05),the positions(r=-0.513,P>0.05)and the pathohistologic types(r=-0.673,P>0.05).The skeletal metastases had significant difference between the clinical stage Ⅲ and Ⅳ,and stage Ⅰ and Ⅱ (χ2=11.9,P<0.01),and between the pathomorphologic types of diffusion and invasion, and the types of polyposis and ulcer (χ2=14.45,P<0.01).Nuclear skeletal imaging should be regularely and routinly performed in patients with gastric carcinoma,especially with clinical stage of Ⅲ and Ⅳ,or/and pathomorphologic types of diffusion and invasion.