583例恶性肿瘤骨转移的临床特征分析

Clinical characteristics of bone metastases:583 cases report

目的总结恶性肿瘤骨转移的临床特征。方法回顾性分析国内6家骨肿瘤治疗中心(济南军区总医院、天津医院、山东大学齐鲁医院、上海市第六人民医院、河北医科大学第三医院、天津肿瘤医院)2010年1月至2015年12月间所有恶性肿瘤骨转移患者的临床资料,按性别、年龄、就诊时间、肿瘤类型、累及部位、四肢病灶有无骨折、治疗方式分别进行统计,分析恶性肿瘤骨转移的临床特征。结果 583例符合纳入标准的恶性肿瘤骨转移患者纳入本研究,其中男性346例(59.3%),女性237例(40.7%);发病年龄20~92岁,以50~69岁为高发年龄,平均(58±12)岁,男性平均发病年龄(59±12)岁,女性平均发病年龄(58±12)岁,差异无统计学意义(t=0.918,P>0.05);按患者就诊时间,2010~2015年每年分别接诊患者28例、62例、93例、114例、143例、143例;按肿瘤类型,肺癌183例、肾癌75例、乳腺癌55例、前列腺癌31例、肝癌28例、甲状腺癌26例、来源不明的肿瘤125例,其他类型肿瘤病例数较少;按照病灶累及的部位,发生于脊柱、躯干的患者197例,发生于骨盆、四肢的患者298例,同时累及多个部位的患者88例;按累及四肢的病灶有无骨折情况,285例患者病灶累及四肢,非病理性骨折157例、病理性骨折128例。结论恶性肿瘤骨转移临床特征在不同性别组、不同年龄组存在差异,对于四肢恶性肿瘤骨转移患者,大龄患者更易发生病理性骨折,肱骨相比股骨更易出现病理性骨折。

Objective To explore the clinical characteristics of bone metastases and to improve the level of diagnosis through analyzing the epidemiological features. Methods Data of 583 patients with bone metastases administered in six orthopedic center （The General Hospital of Jinan Military Commanding Region, Tianjin Hospital, Qilu Hospital, The Six People’s Hospital, The Third Hospital of Hebei Medical University, Tianjing Cancer Hospital） were collected from Jan 2010 to Dec 2015, clinical characteristics including gender, age, position and other essential information were recorded. A multicentric study was applied to analyze the epidemiological features of bone metastases. Results There were 346 males （59.3%） and 237 females （40.7%） in this series. The mean age of all patients was 58±12 years old （range, 20-92 years old）. The mean age of female group was 58±12 years old which was slightly younger than male group （59± 12 years）, no significant differences was observed （t=0.918, P〉0.05）. There was 28 patients with bone metastases accepted treatment in orthopedic center in 2010 while 62 cases in 2011, 93 cases in 2012, 114 cases in 2013 and 143 in 2014 and 2015 equally. Including 183 cases of lung cancer, 75 cases of renal cancer, 55 cases of breast cancer, 31 cases of prostate cancer, 28 cases of liver cancer, 26 cases of thyroid cancer, 125 cases of tumors of unknown origin and other tumors in this study. 197 patients with bone metastases were found in the spine and trunk while 298 patients in limb and pelvis, beyond that 88 patients with multiple bone metastases. A total of 285 patients with bone metastases in limb, 128 patients with pathological fracture while 157 without that were included. Conclusions Clinical characteristic of bone metastases are different in various areas and between different genders. The pathological fracture was more common in the older patients and was more common in humerus than in femur.