食管癌骨转移的临床特征与预后

发布时间：2018-06-29 11:22

本文选题：食管癌 + 转移　；参考：《北京协和医学院》2015年硕士论文

【摘要】：背景目地：食管癌骨转移的临床规律研究较少,尤其对预后因素未作深入探讨,查阅近40年来相关系统研究鲜有报道,本文旨在探讨食管癌骨转移患者的临床特征及预后。研究方法：回顾性分析1981年3月1日至2012年12月30日中国医学科学院肿瘤医院治疗并全部接受骨扫描(ECT)检查的食管癌患者1383例,符合筛选标131例食管癌骨转移患者的资料。全部采用门诊复查和电话随访,骨转移后生存期计算自骨扫描诊断至死亡或末次随访的时间。统计学处理：采用SPSS17.0软件,计数资料比较采用x2检验或非参数检验；生存分析采用Kaplan-Meier法；运用Log-Rank检验进行生存曲线的比较,多因素分析采用Cox回归模型,以P0.05为差异有统计学意义。结果：食管癌骨转移的发生率9.5%,从确诊食管癌至骨转移的中位时间为8.4个月,骨转移后中位生存时间为6.6个月,1年生存率为26.2%。脊柱转移率明显高于其他骨转移部位,其中尤以胸椎转移率最高占23.4%,其次是骨盆49例(20.8%)、肋骨42例(18.2%)、腰椎36例(15.6%)。多发病灶82例(62.6%),单发病灶49例(37.4%)。食管癌不同原发部位之间在骨转移部位的分布上无统计学差异,初诊时有淋巴结转移者骨盆转移率高于无淋巴结转移转移者。单因素分析中,骨痛治疗后缓解、骨转移的治疗、骨盆转移与食管癌骨转移患者的预后有关(均P0.05)。多因素分析中,骨转移的治疗、骨盆转移是食管癌骨转移患者预后的独立因素。结论：食管癌骨转移预后较差,骨盆转移影响预后,放化疗治疗可能给患者带来生存获益。
[Abstract]:Background: there are few studies on the clinical characteristics of bone metastasis of esophageal carcinoma, especially on the prognostic factors. There are few reports on the related systematic studies in the past 40 years. The purpose of this article is to explore the clinical characteristics and prognosis of patients with esophageal cancer bone metastasis. Methods: 1383 patients with esophageal cancer treated by oncology hospital of Chinese Academy of Medical Sciences from March 1981 to December 30, 2012 were analyzed retrospectively. The survival time after bone metastasis was calculated from bone scan diagnosis to death or last follow-up. Statistical processing: using SPSS 17.0 software, counting data were compared by x2 test or non-parametric test, survival analysis by Kaplan-Meier method, Log-Rank test by comparison of survival curve, multivariate analysis by Cox regression model. P0.05 as the difference was statistically significant. Results: the incidence of bone metastasis of esophageal carcinoma was 9.5 months. The median survival time was 8.4 months, the median survival time was 6.6 months, and the 1-year survival rate was 26.2 months. The metastatic rate of spine was significantly higher than that of other bone metastases, especially in thoracic vertebrae, followed by pelvic 49 cases (20.8%), ribs in 42 cases (18.2%) and lumbar vertebrae in 36 cases (15.6%). Multiple lesions were found in 82 cases (62.6%) and single lesions in 49 cases (37.4%). There was no statistical difference in the distribution of bone metastases among different primary sites of esophageal cancer. The pelvic metastasis rate of patients with lymph node metastasis at first diagnosis was higher than that without lymph node metastasis. In univariate analysis, the prognosis of patients with esophageal cancer bone metastasis was related to the remission of bone pain, the treatment of bone metastasis and pelvic metastasis (P0.05). In multivariate analysis, the treatment of bone metastasis and pelvic metastasis are independent prognostic factors of esophageal cancer patients with bone metastasis. Conclusion: the prognosis of esophageal carcinoma with bone metastasis is poor and pelvic metastasis may affect the prognosis. Radiotherapy and chemotherapy may bring survival benefits to the patients.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.1

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