脾脏转移癌41例临床特征及预后分析

Clinical characteristics and prognosis of 41 patients with metastatic carcinoma to the spleen

目的探讨脾脏转移癌的临床特征及预后情况。方法回顾性分析2013年1月至2019年5月就诊于陕西省肿瘤医院的41例脾脏转移癌患者的临床资料,分析脾脏转移癌患者的临床特征、影像学特点、治疗及预后随访情况。结果 41例脾脏转移癌患者中,男性24例,女性17例,年龄(58.49±10.95)岁;原发肿瘤以肺癌最多见,其他还包括胃癌、卵巢癌、结直肠癌等;CT、MRI、正电子发射计算机断层扫描(PET-CT)对脾脏转移癌的临床检出率为100%。脾脏转移癌治疗以姑息性化疗为主,其方案根据原发肿瘤病理类型而定,但孤立性脾脏转移以手术治疗为主。41例患者的中位随访时间为10.6个月,中位生存时间为8.9个月,1年生存率为45.7%。结论脾脏转移癌属于晚期肿瘤,发病率低,临床表现不具特异性,CT、MRI等影像学检查十分重要。早期孤立性脾脏转移癌应以手术治疗为主,脾脏转移同时伴其他脏器转移者应以化疗为主的综合治疗。

Objective To investigate the clinical features and prognosis of metastatic carcinoma to the spleen(MCS).Methods A retrospective analysis was performed on the clinical data of 41 MCS patients from January 2013 to May 2019 in Shaanxi Provincial Cancer Hospital.The clinical characteristics,imaging features,treatment and prognosis of patients were analyzed.Results In 41 patients with MCS,there were 24 males and 17 females,with an average age of(58.49±10.95)years old.Lung cancer was the most common primary tumor,followed by gastric cancer,ovarian cancer and colorectal cancer,etc.The clinical detection rate of CT,MRI and PET-CT was 100% for the diagnosis of MCS.Palliative chemotherapy was the main treatment methord for MCS as an advanced tumor and was conducted depending on its pathological type.However,surgery was performed for solitary spleen metastasis.The median follow-up time of the patients was 10.6 months,the median survival duration was 8.9 months,and the one-year survival rate was 45.7%.Conclusions The incidence of MCS is low,with no specific clinical manifestations.CT and MRI are the first line imaging examinations for MCS.Early solitary MCS is mainly treated by surgery,and the patients with MCS accompanied by other organ metastases should be treated with chemotherapy.