胃癌术后36例骨转移的分析

Clinical Assessment of Bone Metastasis in36Postoperative Gastric Cancer Patients

目的:探讨胃癌术后骨转移的特点,从而得到早期诊断和治疗。方法:1996年11月至1999年11月在我科进行全身骨核素显像的254例胃癌术后患者中的36例有骨转移者,从病理、有无淋巴结转移、有否其它脏器转移、骨转移部位、胃癌术后距骨转移时间及骨转移后生存情况进行探讨和分析。结果:36例胃癌术后骨转移中以低分化腺癌为多,各站淋巴结转移无明显差异。凡有骨转移者几乎同时伴有其他脏器转移,骨转移部位以脊柱为多,多发骨转移者占骨转移的47.2%。胃癌术后发生骨转移的时间最短2个月,最长14年,平均38个月。36例胃癌骨转移中,27例均在发生骨转移后2个月至13个月死亡。结论:胃癌较少转移至骨,一旦发生骨转移,表明病变已属晚期。胃癌患者应定期进行骨核素显像,以早期发现骨转移,为早期治疗提供可靠的诊断依据。

Objective:To investigate the features of bone metastasis after gastric cancer op eration and the early diagnosis and treatment of it.Methods:Thirty-three bone metastases were diagnosed in systemic nuclide scintiscanning of254cases after gastric cancer operation in the period of1996November to1999April.The pathologic changes,metastases of lymph node or other organs,metastatic area,metastatic time after gastric operation and the survival status of the patients were discussed and analysed.Results:Among36bone metastasis patients,most of them were poorly differentiated adenocarcinoma.No obvious differnece between the metastatic areas of lymph nodes,but all of them had metastases of other organs mainly on the spine,and multiple bone metastases consisted of47.2%.The shortest time of metastasis after gastric operation was2months,the longest time 14years with a mean time of38months.Eight patients were still alive up now and the others died in6to13months after metastasis.Conclusion:Although bone metastasis after gastric cancer operation is quite rare,but it usually indicates the late event of gastric cancer.Early discovery of bone metastasis by periodic systemic nuclide scintiscanning may provide a reliable basis for early treatment.