肺癌骨转移的诊断和临床特征分析

Diagnosis and clinical feature of lung cancer with bone metastasis

目的总结分析肺癌骨转移的临床特点并探讨其诊断方法。方法临床资料回顾性分析60例肺癌骨转移患者的临床特征和最佳检查方法。结果肺癌骨转移的早期阶段患者临床主要表现为不同程度的疼痛,亦可无临床症状。60例肺癌骨转移患者中腺癌35例(58.3%),鳞癌16例(26.7%),小细胞肺癌7例(11.7%),混合癌2例(3.3%)。骨转移部位有胸部70.0%,脊柱65.0%,骨盆53.3%,四肢45.0%,头颅38.3%。结论肺癌骨转移以多发性、溶骨性骨破坏为特征。腺癌骨转移发生率最高,其次为鳞癌及小细胞癌。通过放射性核素显像(ECT)、X线平片、电子计算机断层扫描(CT)、磁共振(MRI)能协助肺癌骨转移的诊断。

Objective To review clinical feature of lung cancer with bone metastasis and explore its diagnosed method. Methods The clinical materials were retrospectively analysed for clinical feature and best detection of 60 cases in lung cancer with bone metastasis. Results Patients of lung cancer with bone metastasis in early stage performed pain with different extent, or no clinical symptom either. In all the 60 cases, 58.3% were adenocarcinoma, 26.7% were squamous carcinoma, 11.7% were small cell lung cancer, 3.3% were mixed carcinoma. The frequencies of metastasis sites were as follows, eg, ribs（70.0% ）, spine （65.0%） , pelvis（53.3% ）, limbs（45.0% ）and skull（38.3% ）. Conclusions Bone metastasis in lung cancer is characterized by multiple osteolytic damages. Adenocarcinoma is one of the most common types of lung cancer that causes bone metastasis, while squamous carcinoma and small cell lung cancer are in the next place. ECT bone scan, X-ray, CT, and MRI are effective methods for early diagnosis of lung cancer with bone metastasis.