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目的分析卵巢恶性肿瘤骨转移的临床特征、危险因素和预后情况。方法回顾性分析中国医学科学院肿瘤医院1984年1月至2008年12月收治的15例卵巢恶性肿瘤骨转移患者的临床病理资料。结果 (1)15例患者发生脊椎转移17例次;骨盆转移6例次;四肢骨转移4例次。15例患者腰痛7例次;胸痛4例次;行走障碍2例次。(2)6例卵巢癌Ⅳ期患者诊断的同时发现骨转移5例;7例Ⅲ期患者5例骨转移发生在卵巢癌诊断后1～2年;1例Ⅰ期患者发生骨转移的时间为卵巢癌确诊后3年。(3)11例卵巢上皮性肿瘤发生骨转移患者中,低、中分化浆液性乳头状腺癌8例;高分化浆液性乳头状腺癌1例;透明细胞癌2例;15例卵巢肿瘤患者诊断骨转移同时发生肺转移6例次,肝转移3例次,淋巴结转移7例次。(4)15例患者中放弃治疗5例,其生存时间2～5个月;10例接受骨转移综合治疗的患者,其生存时间1个月至23年。结论卵巢恶性肿瘤骨转移多见于Ⅲ～Ⅳ期患者,以腰椎、胸椎、骨盆为主要转移部位,卵巢低分化浆液性乳头状腺癌为常见病理类型,临床期别晚、肺转移、淋巴结转移和低分化是发生骨转移的危险因素。卵巢肿瘤骨转移预后很差,采用放化疗为主的综合治疗可提高生存质量,延长生存期。
Objective To analyze the clinical features, risk factors and prognosis of ovarian cancer with bone metastases. Methods The clinicopathological data of 15 patients with malignant transformation of ovarian cancer who were admitted to Cancer Hospital of Chinese Academy of Medical Sciences from January 1984 to December 2008 were retrospectively analyzed. Results (1) There were 17 cases of spondylolisthesis in 15 cases, 6 cases of pelvic metastasis and 4 cases of bone metastases in the extremities. 15 cases of low back pain in 7 cases; chest pain in 4 cases; walking obstacles in 2 cases. (2) 5 cases of bone metastases were diagnosed in 6 cases of ovarian cancer and 5 cases of bone metastases in 5 cases of 7 cases of stage Ⅲ ovarian cancer; 1 case of bone metastases in 1 case of stage Ⅰ was 3 years after diagnosis of ovarian cancer. (3) Among 11 cases of epithelial ovarian tumor with bone metastases, 8 cases had low or moderately differentiated serous papillary adenocarcinoma, 1 case had highly differentiated serous papillary adenocarcinoma, 2 cases had clear cell carcinoma, 15 cases had ovarian cancer Diagnosis of bone metastases occurred in 6 cases of lung metastasis at the same time, liver metastases in 3 cases, 7 cases of lymph node metastasis. (4) 5 patients were abandoned in 15 patients and their survival time was 2 to 5 months. The survival time of 10 patients who received comprehensive treatment of bone metastasis ranged from 1 month to 23 years. Conclusions Bone metastasis of ovarian cancer is more common in patients with stage Ⅲ ~ Ⅳ, with lumbar, thoracic and pelvic as the main metastatic sites. Poorly differentiated ovarian serous papillary adenocarcinoma is a common pathological type, late clinical stage, lung metastasis, lymph node metastasis and Poorly differentiated is a risk factor for bone metastasis. Ovary tumor bone metastasis prognosis is poor, the use of radiotherapy and chemotherapy-based comprehensive treatment can improve the quality of life and prolong survival.