非小细胞肺癌患者术后发生骨转移的危险因素

Risk Factors of Non-small Cell Lung Cancer with Bone Metastasis after Therapy

背景与目的肺癌目前是死亡率最高的肿瘤,非小细胞肺癌(non-small cell lung cancer,NSCLC)患者在手术后通常会发生远处转移,如骨转移、脑转移、肺转移等。本研究旨在探究NSCLC患者术后发生骨转移的危险因素。方法选择本院于2009年5月-2011年5月确诊收治的NSCLC患者176例,按照是否发生骨转移将患者分为两组,即骨转移组和无骨转移组。对比两组患者的一般临床病理资料,并通过多因素分析对比发生骨转移的独立危险因素。结果 NSCLC患者的一般临床病理资料中血栓与否,肿瘤-淋巴结-转移(tumor-node-metastasis,TNM)分期与是否发生骨转移关系密切,有统计学意义(均P<0.01);在两组患者的凝血功能指标中发现凝血酶原时间、活化部分凝血酶活酶时间、纤维蛋白原、凝血酶时间、血小板计数、D-二聚体以及碱性磷酸酶之间存在明显的差异性,有统计学意义(均P<0.05);Logistic回归分析发现纤维蛋白原、碱性磷酸酶、T4期、N3期和D-二聚体为NSCLC患者发生骨转移的独立危险因素。结论纤维蛋白原、活化部分凝血酶活酶时间、碱性磷酸酶、T3期、N2期和D-二聚体为NSCLC患者发生骨转移的独立危险因素。

Background and objective Lung cancer is the leading cause of cancer-related deaths, patients with non-small cell lung cancer（NSCLC） usually have distant metastases, such as bone metastasis, brain metastasis, and lung metastasis. The purpose of this study was to explore the risk factors for bone metastasis in NSCLC patients. Methods A total of 176 cases of NSCLC were selected from May 2009 to May 2011, and patients were divided into two groups, namely the bone metastasis group and non-bone metastasis group. The general clinicopathological data of the two groups and analyzing the independent risk factors of bone metastasis were compared. Results In the general clinicopathological data of NSCLC patients. The thrombus or not and tumor-node-metastasis（TNM） stage were closely related to the occurrence of bone metastasis, and were statistically significant（all P〈0.01）. Prothrombin time, activated partial thromboplastin time, Fibrinogen, thrombin time, blood platelet, D-Dimer and alkaline phosphatase have significantly difference between the two groups（all P〈0.05）. Logistic regression analysis showed that fibrinogen, activated partial thromboplast in time, alkaline phosphatase, T4 phase, N3 phase and d-dimer were independent risk factors for bone metastasis in NSCLC patients. Conclusion Fibrinogen, alkaline phosphatase, T3, N2 stage and D-Dimer is the independent risk factors of bone metastases in patients with NSCLC.