非小细胞肺癌发生骨转移的危险因素分析

Analysis of risk factors influencing the bone metastasis of non-small cell lung cancer

目的:探讨影响非小细胞肺癌骨转移的危险因素。方法:选取2015年至2019年在南京医科大学第二附属医院住院治疗的非小细胞肺癌患者207例[骨转移组(n=113)、无骨转移组(n=94)]。检测血清CA125、CEA、NSE、CYFRA21-1、LDH和ALP的水平,记录年龄、性别、吸烟史、高血压、糖尿病、临床分期、肿瘤位置、组织学类型和淋巴结转移等因素。采用单因素和Logistic多因素回归分析筛选影响非小细胞肺癌患者骨转移的危险因素。结果:单因素分析结果发现两组临床分期、淋巴结转移、CA125、CEA、NSE、CYFRA21-1、LDH比较具有统计学差异(P<0.05);NSE、CYFRA21-1在腺癌和鳞状细胞癌血清中水平无统计学差异(P>0.05);Logistic多因素回归分析结果显示,临床分期、淋巴结转移和CA125是影响非小细胞肺癌患者骨转移的主要因素(P<0.01)。结论:临床分期、淋巴结转移和CA125是影响非小细胞肺癌患者骨转移的独立危险因素,为临床早期治疗提供重要的指导意义。

Objective:To clarify the risk factor for bone metastasis(BM)with non-small cell lung cancer.Methods:A total of 207 patients with non-small cell lung cancer(NSCLC),obtained from the Second Affiliated Hospital of Nanjing Medical University during the period of 2015 to 2019,were enrolled in this study[bone metastasis group(n=113),non-bone metastasis group(n=94)].The levels of cancer antigen 125(CA125),carcinoembryonic antigen(CEA),cytokeratin-19 fragment(CYFRA21-1),neuron specific enolase(NSE),alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)were measured.Information about NSCLC patients such as age,gender,smoking history,hypertension,diabetes,histopathological type,clinical stage,tumor location and lymph node metastasis was collected from medical records.Univariate and multivariate Logistic regression were used to evaluate the association between risk factors and bone metastasis.Results:There was a statistically significant difference in CA125,CEA,CYFRA21-1,NSE,LDH,clinical stage and lymph node metastasis between two groups(P<0.05).The levels of serum NSE and CYFRA21-1 in adenocarcinoma and squamous cell carcinoma was not statistically different(P>0.05).Multivariate Logistic regression analysis showed that the factors associated with bone metastasis were CA125,clinical stage and lymph node metastasis(P<0.01).Conclusion:CA125,clinical stage and lymph node metastasis were risk factors that affect the bone metastasis of NSCLC and provide important guiding significance for clinical prevention and treatment.