[1]郑凯,于秀淳,胡永成,等.583例恶性肿瘤骨转移的临床特征分析[J].中华老年骨科与康复电子杂志,2017,(03):129-135.[doi:10.3877/cma.j.issn.2096-0263.2017.03.001]
　Zheng Kai,Yu Xiuchun,Hu Yongcheng,et al.Clinical characteristics of bone metastases: 583 cases report[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(03):129-135.[doi:10.3877/cma.j.issn.2096-0263.2017.03.001]
点击复制

583例恶性肿瘤骨转移的临床特征分析()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年03期
页码:
129-135
栏目:
论著
出版日期:
2017-06-01

文章信息/Info

Title:
Clinical characteristics of bone metastases: 583 cases report
作者:
郑凯1; 于秀淳1; 胡永成2; 李建民3; 董扬4; 张国川5; 王国文6; 徐明1
250031 济南军区总医院骨病科 1；300211 天津市天津医院骨肿瘤科 2；250002 济南，山东大学齐鲁医院骨科 3；200233 上海第六人民医院骨肿瘤科 4；050051 石家庄，河北医科大学附属第三医院骨肿瘤科 5；300210 天津肿瘤医院骨肿瘤科 6
Author(s):
Zheng Kai1;  Yu Xiuchun1;  Hu Yongcheng2;  Li Jianmin3;  Dong Yang4;  Zhang Guochuan5;  WangGuowen6;  Xu Ming1
1Department of Orthopaedics, The General Hospital of Jinan Military Commanding Region, Jinan 250031, China; 2Department of Bone Oncology, Tianjin Hospital, Tianjing Medical University, Tianjin 300211, China; 3Department of Orthopaedics, Qilu Hospital, Shandong University, Jinan 250002, China; 4Department of Bone Oncology, The Six People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China; 5Department of Bone Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China; 6Department of Bone Oncology, Tianjing Cancer Hospital, Tianjing 300210, China
关键词:
肿瘤转移;  骨肿瘤;  多中心研究;  临床特征
Keywords:
Neoplasms metastasis;  Bone neoplasms;  Multicenter study;  Clinical characteristics
DOI:
10.3877/cma.j.issn.2096-0263.2017.03.001
文献标志码:
A
摘要:
目的 总结恶性肿瘤骨转移的临床特征。方法 回顾性分析国内 6家骨肿瘤治疗中心（济南军区总医院、天津医院、山东大学齐鲁医院、上海市第六人民医院、河北医科大学第三医院、天津肿瘤医院）2010年 1月至 2015年 12月间所有恶性肿瘤骨转移患者的临床资料，按性别、年龄、就诊时间、肿瘤类型、累及部位、四肢病灶有无骨折、治疗方式分别进行统计，分析恶性肿瘤骨转移的临床特征。结果 583例符合纳入标准的恶性肿瘤骨转移患者纳入本研究，其中男性 346例（59.3%），女性 237例（40.7%）；发病年龄20～92岁，以50～69岁为高发年龄，平均（58±12）岁，男性平均发病年龄（59±12）岁，女性平均发病年龄（58±12）岁，差异无统计学意义（t=0.918，P＞0.05）；按患者就诊时间，2010～2015年每年分别接诊患者 28例、62例、93例、114例、143例、143例；按肿瘤类型，肺癌 183例、肾癌 75例、乳腺癌 55 例、前列腺癌 31例、肝癌 28例、甲状腺癌 26例、来源不明的肿瘤 125例，其他类型肿瘤病例数较少；按照病灶累及的部位，发生于脊柱、躯干的患者 197例，发生于骨盆、四肢的患者 298例，同时累及多个部位的患者 88例；按累及四肢的病灶有无骨折情况，285例患者病灶累及四肢，非病理性骨折 157例、病理性骨折 128例。结论 恶性肿瘤骨转移临床特征在不同性别组、不同年龄组存在差异，对于四肢恶性肿瘤骨转移患者，大龄患者更易发生病理性骨折，肱骨相比股骨更易出现病理性骨折。
Abstract:
Objective To explore the clinical characteristics of bone metastases and to improve the level of diagnosis through analyzing the epidemiological features. Methods Data of 583 patients with bone metastases administered in six orthopedic center (The General Hospital of Jinan Military Commanding Region, Tianjin Hospital, Qilu Hospital, The Six People’s Hospital, The Third Hospital of Hebei Medical University, Tianjing Cancer Hospital) were collected from Jan 2010 to Dec 2015, clinical characteristics including gender, age, position and other essential information were recorded. A multicentric study was applied to analyze the epidemiological features of bone metastases. Results There were 346 males (59.3%) and 237 females (40.7%) in this series. The mean age of all patients was 58±12 years old (range, 20-92 years old). The mean age of female group was 58±12 years old which was slightly younger than male group (59± 12 years), no significant differences was observed (t=0.918, P>0.05). There was 28 patients with bone metastases accepted treatment in orthopedic center in 2010 while 62 cases in 2011, 93 cases in 2012, 114 cases in 2013 and 143 in 2014 and 2015 equally. Including 183 cases of lung cancer, 75 cases of renal cancer, 55 cases of breast cancer, 31 cases of prostate cancer, 28 cases of liver cancer, 26 cases of thyroid cancer, 125 cases of tumors of unknown origin and other tumors in this study. 197 patients with bone metastases were found in the spine and trunk while 298 patients in limb and pelvis, beyond that 88 patients with multiple bone metastases. A total of 285 patients with bone metastases in limb, 128 patients with pathological fracture while 157 without that were included. Conclusions Clinical characteristic of bone metastases are different in various areas and between different genders. The pathological fracture was more common in the older patients and was more common in humerus than in femur.

参考文献/References:

1 Bedard G, Wong E, Goh P, et al. Handbook of Bone Metastases (2nd edition) [M]. Toronto, Bayer HealthCare Pharmaceuticals Inc, 2014, 3-5．
2 Cheung FH. The practicing orthopedic surgeon’s guide to managing long bone metastases [J]. Orthop Clin NorthAm, 2014, 45(1): 109-119.
3 Weber KL, Randall RL, Grossman S, et al. Management of lower-extremity bone metastasis [J]. J Bone Joint Surg Am, 2006, 88(suppl 4): 11-19.
4 Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity [J]. Clin Cancer Res, 2006, 12(20 Pt 2): 6243s- 6249s.
5 Roodman GD. Mechanisms of bone metastases [J]. N Engl J Med, 2004, 350(16): 1655-1664.
6 eI-Khoury GY, Dalinka MK, Alazraki N, et al. Metastatic bone disease. America College of Radiology. ACR Appropriateness Criteria [J]. Radiology, 2000, 215: 283-293.
7 Yang Y, Ma Y, Sheng J, et al. A multicenter, retrospective epidemiologic survey of the clinical features and management of bone metastatic disease in China [J]. Chin J Cancer, 2016, 35(1): 40.
8 Yong M, Jensen AÖ, Jacobsen JB, et al. Survival in breast cancer patients with bone metastases and skeletal-related events: a populationbased cohort study in Denmark (1999-2007) [J]. Breast Cancer Res Treat, 2011, 129(2): 495-503.
9 Sathiakumar N, Delzell E, Morrisey MA, et al. Mortality following bone metastasis and skeletal-related events among men with prostate cancer: a population- based analysis of US Medicare beneficiaries, 1999-2006 [J]. Prostate Cancer Prostatic Dis, 2011, 14(2): 177-183.
10 Forsberg JA, Eberhardt J, Boland PJ, et al. Estimating survival in patients with operable skeletal metastases: an application of a bayesian belief network [J]. PLoS One, 2011, 6(5): e19956.
11 Ratasvuori M, Wedin R, Hansen BH, et al. Prognostic role of en-bloc resection and late onsetof bone metastasis in patients with bone-seeking carcinomas ofthe kidney,breast,lung,and prostate:SSG study on 672 operatedskeletal metastases [J]. J Surg Oncol, 2014, 110(4): 360- 365.
12 Coleman R, Body JJ, Aapro M, et al. Bone health in cancer patients: ESMO clinical practice guidelines [J]. Ann Oncol, 2014, 25(Suppl 3): iii124-137.
13 Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 [J]. Int J Cancer, 2010, 127(12): 2893-2917.
14 Li S, Peng Y, Weinhandl ED, et al. Estimated number of prevalent cases of metastatic bone disease in the US adult population [J]. Clin Epidemiol, 2012, 4: 87-93.
15 Siegel R, Ma JM, Zou ZH, et al. Cancer statistics, 2014 [J]. CA Cancer J Clin, 2014, 64(1): 9-29.
16 Chen WQ, Zheng RS, Zeng HM, et al. The updated incidences and mortalities of major cancers in China, 2011 [J]. Chin J Cancer, 2015, 34(3): 502-507.
17 Ruggieri P, Mavrogenis AF, Casadei R, et al. Protocol of surgical treatment of long bone pathological fractures [J]. Injury, 2010, 41 (11): 1161-1167.
18 Ward WG, Holsenbeck S, Dorey FJ, et al. Metastatic disease of the femur: surgical treatment [J]. Clin Orthop Relat Res, 2003, 415(Suppl):S230-S244.

备注/Memo

备注/Memo:
 基金项目：天津市卫生局课题（15KG124）
更新日期/Last Update: 2017-06-01