42例直肠癌术后骨转移患者的临床病理特征及预后分析

Clinicopathological features and prognosis analysis of postoperative bone metastasis of rectal cancer:a series of 42 cases

目的 分析42例直肠癌术后骨转移患者的临床病理特征及预后。方法 回顾性分析2016年1月1日至2021年1月1日于本中心诊断直肠癌术后骨转移的42例患者的临床资料,记录骨转移的诊断率、诊断方式,以及患者的临床病理特征、接受针对骨转移的治疗情况和诊断骨转移之后的生存情况。结果 直肠癌术后骨转移的诊断率为1.1%(42/3 861),6例患者经影像学检查诊断并经病理确诊,36例经影像学检查诊断。42例患者中,男性居多,患者中位年龄数值为56.0,术前CEA、CA199水平正常者居多;在新辅助治疗与辅助治疗方面,大多患者接受了化疗;组织病理学类型例数由多及少分别为管状腺癌、黏液腺癌、印戒细胞癌;微卫星稳定的肿瘤更多见。共有17例患者接受了化疗、3例患者接受了放化疗,其余患者未接受针对性的治疗。42例患者诊断骨转移之后的中位生存期为7.2个月。结论 直肠癌术后患者诊断骨转移的概率低,接受了化疗的患者、组织病理学类型为管状腺癌的患者和肿瘤为微卫星稳定型的患者更多见,患者的预后较差。

Objectives To analyze the clinicopathological features and prognosis of 42 patients with postoperative bone metastasis of rectal cancer.Methods The clinical data of 42 patients diagnosed with postoperative bone metastasis of rectal cancer in our center from January 1,2016,to January 1,2021,were retrospectively analyzed.The diagnostic rate and diagnostic methods of bone metastasis,as well as the clinicopathological features,treatment for bone metastasis,and survival after being diagnosed with bone metastasis,were recorded.Results The diagnostic rate of postoperative bone metastasis of rectal cancer was 1.1%(42/3,861).Six patients were diagnosed by imaging examination and confirmed by pathology,and 36 patients were diagnosed by imaging examination.Among the 42 patients,most were male,with a median age of 56.0.Most patients had normal preoperative carcinoembryonic antigen and carbohydrate antigen199 levels.In terms of neoadjuvant and adjuvant therapy,most patients received chemotherapy.The number of cases of histopathological types was tubular adenocarcinoma,mucinous adenocarcinoma,and signet ring cell carcinoma in descending order.Microsatellite stable tumors were more common.A total of 17 patients received chemotherapy,3 patients received radiotherapy and chemotherapy,and the remaining patients did not receive treatment for bone metastasis.The median survival time after being diagnosed with bone metastasis was 7.2 months in 42 patients.Conclusion The diagnostic rate of postoperative bone metastasis in patients with rectal cancer is low.Patients who have received chemotherapy,those with histopathological type of tubular adenocarcinoma,and those with microsatellite stable tumors are more common.The prognosis of these patients is poor.