75例大肠癌骨转移预后影响因素的回顾性分析

Prognostic factors of large bowel carcinoma with bony metastasis:a retrospetive analysis of 75 cases

目的探讨75例大肠癌骨转移患者的临床特征及其相关的预后影响因素。方法以该院2002年3月-2012年2月间诊治的75例大肠癌骨转移患者为研究对象,对其临床资料进行回顾性分析。结果大肠癌确诊后,3年生存率为49.4%,中位生存期为(32.6±2.8)个月,大肠癌骨转移确诊后,3年生存率为26.8%,中位生存期为(11.3±3.2)个月。单因素分析发现:大肠癌骨转移时血清ALP≥150 U.L-1、伴有淋巴结转移、伴有其他脏器转移以及骨转移灶多发对大肠癌骨转移的预后有影响,对上述4项危险因素进行Logistic回归分析,发现骨转移时ALP≥150 U.L-1和骨转移时伴有其他脏器转移是影响大肠癌骨转移预后的独立危险因素。结论大肠癌骨转移时ALP水平及骨转移时伴有其他脏器转移是影响其预后生存率的独立危险因素,对于判断预后、指导术后治疗及制订随访方案具有重要作用。

Objective To investigate the clinical features and associated prognostic factors of large bowel carcinoma with bony metastasis in 75 patients. Methods We made a retrospective analysis on the clinical data of 75 patients with large bowel carcinoma with bony metastasis diagnosed and treated in our hospital from March 2002 to February 2012. Results After diagnosis of large bowel carcinoma,the 3-year survival rate was 49.4% , with a median survival time （ 32.6 ± 2.8 ） months, and after diagnosis of bony metastasis, the 3-year survival rate was 26.8% , with a median survival time（ 11.3 ± 3.2）months. Univariate analysis showed when bony metastasis occurred, the serum ALP〉 150 U . L-1, accompanied by lymph node metastasis, other organ metastasis and multiple bone metastases, which would made a difference on the prognosis of large bowel carcinoma with bony metastasis, and the Logistic regression analysis on the above four risk factors showed that the serum ALP levels and accompanied other organ metastasis were independent risk factors for the prognosis of large bowel carcinoma with bony metastasis. Conclusion The ALP levels and accompanied other organ metastasis are independent risk factors for the prognosis of large bowel carcinoma with bony metastasis which have an important role for judging prognosis, guiding treatment and formulating the follow-up program.