胃癌骨转移60例临床病理特点及预后因素分析

Clinicopathological Features and Prognostic Factors of Bone Metastasis in 60 Cases of Gastric Cancer

目的探讨胃癌骨转移临床病理特点及预后影响因素,为患者癌细胞转移的临床治疗提供参考。方法选取胃癌骨转移患者60例,采用Kaplan-Meier法进行生存分析,采用Log-rank检验对预后影响因素进行单因素分析,Cox回归模型对生存影响因素进行多因素分析。结果行化疗治疗的胃癌骨转移患者的生存期长于未行化疗治疗的患者;初诊时ECOG评分为0～2的胃癌骨转移患者生存期长于评分> 2的患者;无其他部位转移(合并骨外转移)的患者生存期长于合并淋巴结、肝肺等部位转移的患者。单因素分析显示,骨痛症状、分化程度、骨转移数目、骨转移部位、合并骨外转移、初诊临床分期、初诊时ECOG评分、化疗是影响胃癌骨转移的预后因素(P <0. 05);多因素分析显示:合并骨外转移、初诊时ECOG评分和化疗是影响胃癌骨转移患者的独立因素,合并骨外转移是最大的危险因素。结论胃癌骨转移患者的预后差,预后受多种因素影响,积极采用综合治疗有助于延长患者的生存时间。

Objective To investigate the clinicopathological features and prognostic factors of bone metastasis in gastric cancer,and to provide reference for the clinical treatment of cancer cells after metastasis.Methods 60 patients with gastric cancer metastasis were retrospectively analyzed,and the prognostic factors were analyzed with follow-up data.The survival factor was analyzed by Kaplan-Meier method.The prognostic factors were analyzed by Log-rank test.Cox regression model was used to analyze the factors of survival.Results The survival time of patients with metastatic gastric cancer was longer than patients who had not undergone chemotherapy.At the time of initial diagnosis,the patients with gastric cancer with ECG score 0~2 had a longer survival than those with score>2 Part of the transfer(combined with external bone metastases)in patients with longer survival than lymph nodes,liver and lung and other parts of the transfer of patients.Univariate analysis showed that bone pain,differentiation,number of bone metastases,bone metastases,combined with external metastases,newly diagnosed clinical staging,ECOG score at the time of initial diagnosis,and chemotherapy were prognostic factors for bone metastasis of gastric cancer(P<0.05).Multivariate analysis showed that ECOG score and chemotherapy were the independent prognostic factors of bone metastasis in patients with gastric cancer,and the combination of extracorporeal metastasis was the greatest risk factor.Conclusion The prognosis of patients with bone metastases in gastric cancer is poor and the prognosis is affected by many factors.Active treatment is helpful to prolong the survival time of patients.