以指骨转移为首发症状肺癌23例临床分析

The Clinical Analysis of 23 Patients with Metastases in Phalanges as First Symptoms of Primary Lung Cancer

目的探讨原发性肺癌单纯以指骨转移为首发症状的临床特点以及肺癌发生指骨转移的机制。方法搜集自1991年至2010年见诸于各专业文献报道的单纯以指骨转移为首发症状的原发性肺癌患者的资料,并进行综合性分析。结果在文献报道的单纯以指骨转移为首发症状的23例原发性肺癌中,其转移病灶位于左手指骨者10例,右手指骨者12例,双手指骨者1例,指骨转移病灶的数量在两手之间的分布大致相等。除3例患者转移病灶位于近节指骨外,其余患者的转移病灶均位于末节指骨。有7例患者的患病手指既往曾有外伤史。结论传统的机械-解剖学说和种子-土壤学说的观点均不能解释原发性肺癌发生指骨转移的机制;临床上如遇久治不愈的手指软组织炎症时,应考虑是否有肺部肿瘤细胞转移至此的可能性。

Objective To research the clinical characteristics of patients with metastases in phalanges as first symptoms of primary lung cancer and the mechanism of tumor metastases to phalanges. Methods The clinical data of patients with metastases in phalanges as first symptoms of primarylung cancer published between 1991 and 2010 were reviewed,and were synthetically analyzed. Results Of all the 23 patients with metastases in phalanges as first symptoms of primary lung cancer. Ten patients＇ metastatic lesions located in their phalanges of left hands, 12 patients＇ in right hands and 1 patient＇s in both hands. The distribution of the quantity of the phalangeal metastases between two hands was almost equal. Three patients＇ metastatic lesions were situated in proximal phalanges of fingers, and the rest in distal. Seven patients＇ ill fingers had trauma history. Conclusion Neither the traditional machine anatomy theory, nor seed-soil theory can explain the mechanism of primary lung carcinoma metastasizing to phalanges of fingers. If patients with soft tissue inflammation of fingers that cannot be healed for a long time are encountered, the possibility of tumor metastasis here should be considered.