初诊食管鳞状细胞癌骨转移影像学筛查分析与研究

Analysis of bone metastasis screening by radiological examination for newly diagnosed patients with esophageal squamous carcinoma

目的:通过对376例初诊食管鳞状细胞癌患者骨转移影像学筛查资料分析,探讨骨转移发生率及骨转移影像学筛查的必要性。方法:回顾性分析2015年3月—2017年6月经病理确诊为食管鳞状细胞癌并行骨转移筛查患者376例,对性别、年龄、肿瘤位置、cT、cN、cTNM、疼痛等临床资料进行统计学分析,评估与骨转移结果相关性。结果:初诊食管鳞状细胞癌骨转移率6.4%(24/376),骨转移组在性别、肿瘤位置、cT、cN、cTNM指标上与骨转移阴性组无统计学差异(P>0.05)。但在疼痛、高龄、M1分期上具有显著统计学差异(P<0.05)。多因素二元Logistic回归分析,疼痛、高龄、M1均为骨转移独立预测因子。通过对cT、cN进行亚组分析,Tis-2N0M0期骨转移占总转移例数的29.2%(7/24)。结论:任何cT、cN、cM初诊食管鳞状细胞癌患者均可发生骨转移,应首选骨扫描进行骨转移筛查,尤其是伴有疼痛症状、高龄、远处转移者。

Objective： By analyzing the clinical characteristics of newly diagnosed 376 patients with esophageal squamous carcinoma, to evaluate the incidence of bone metastasis and discuss the necessity of bone scintigraphy for bone metastasis screening. Methods： We retrospectively reviewed the charts of 376 consecutive patients with a pathology diagnosis of esophageal squamous carcinoma in our department between March 2015 and June 2017, and evaluated gender, age, tumor lo- cation, TNM staging, and pain. Results： The rate of bone metastasis was 6.4%（24/376）, the pain, M1, and agedness were sig- nificantly higher （P〈0.05） in positive patients with bone metastasis than negative patients, but no significant difference in gen- der, tumor location, cT, cN, cTNM staging （P〉0.005）. Multivariate binary logistic regression analysis suggested that pain, M1, agedness were independent predictors of bone metastasis. Among 24 patients with bone metastasis, 29.2%（7/24） cases were Tis-2NOMO. Conclusions： For newly diagnosed patients with esophageal squamous carcinoma, bone metastasis may occur in patients with any cT, cN, cTNM and tumor location. Bone scintigraphy was necessary and the first preferred imageological ex amination for bone metastasis screening, especially for patients with M1, pain and advanced age.