肝细胞肝癌骨转移的临床特征及预后分析

发布时间：2018-07-21 10:24

【摘要】：目的:肝细胞肝癌骨转移在我国的发病率不断上升。本研究意在分析肝细胞肝癌骨转移的临床特征,影响预后的因素以及原发灶、转移灶的不同治疗方法对癌症患者的影响。方法:本研究纳入了浙江大学附属第一医院骨科自2010年1月至2014年12月期间诊疗的肝细胞肝癌骨转移患者,回顾性分析其临床特征,预后因素并比较了不同治疗方式对患者的影响。结果:患者的平均年龄为54岁,共有38名男性和5名女性。躯干为最常见的转移部位(74.0%),14名病人的骨转移并发软组织包块(32.5%)。90.7%的骨转移为溶骨成骨混合型,大部分骨转移为多发性骨转移(69.8%)。骨转移诊断后的平均生存期为11月。多因素分析中,骨转移后的生存期和Karnofsky功能评分(P=0.008),Child评分(P0.001)相关。肝细胞肝癌诊断至出现骨转移的时间与UCSF评分(P0.001)以及原发灶的治疗方式(P0.001)相关。肝移植患者较少地伴发了软组织包块。原发灶行肝移植及肿瘤切除的患者的肝内灶控制情况较保守治疗患者好。结论:肝细胞肝癌骨转移后影响患者生存期的独立预后因素是Karnofsky功能评分和Child评分。肝细胞肝癌骨转移患者能从先前的肝移植和肿瘤切除术获益。
[Abstract]:Objective: the incidence of bone metastasis of hepatocellular carcinoma (HCC) in China is increasing. The purpose of this study was to analyze the clinical features of bone metastasis of hepatocellular carcinoma (HCC), the factors affecting prognosis and the influence of different treatment methods of primary tumor and metastatic foci on cancer patients. Methods: this study included patients with bone metastasis of hepatocellular carcinoma (HCC) from January 2010 to December 2014 in the Orthopaedics Department of the first affiliated Hospital of Zhejiang University. Prognostic factors and effects of different treatment methods on patients were compared. Results: the average age of the patients was 54 years old. There were 38 males and 5 females. Bone metastasis with soft tissue mass (32.5%). 90.7% of the bone metastases were mixed osteolytic osteoblasts, and most of the bone metastases were multiple bone metastases (69.8%). The average survival time after diagnosis of bone metastasis was 1 month. In multivariate analysis, survival time after bone metastasis was correlated with Karnofsky function score (P0. 008) and Child score (P0. 001). The time from diagnosis to bone metastasis was correlated with the UCSF score (P0.001) and the treatment of primary tumor (P0.001). Liver transplantation patients are less accompanied by soft tissue mass. Patients with primary liver transplantation and tumor resection had better intrahepatic focus control than conservatively treated patients. Conclusion: Karnofsky score and Child score are the independent prognostic factors influencing survival after bone metastasis of hepatocellular carcinoma. Patients with bone metastases from hepatocellular carcinoma can benefit from previous liver transplantation and tumor resection.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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