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目的分析影响以骨转移为首发表现的非小细胞肺癌(NSCLC)患者的预后的因素。方法回顾性分析2010年8月至2012年8月安徽医科大学附属省立医院及安徽省肿瘤医院确诊的以骨转移为首发表现的46例NSCLC患者资料,采用Kaplan-Meier法分析临床病理特征(年龄、性别、吸烟、病理类型、骨转移灶数目、骨相关事件、其他部位转移、ECOG评分、碱性磷酸酶及癌胚抗原)与总生存期(OS)的关系,同时采用多因素Cox模型分析影响患者OS的独立因素。结果全组患者中位OS为237天。单因素分析显示,病理类型、骨转移灶数目及初诊时ECOG评分为影响OS因素,其中鳞癌、骨转移灶数目≥2个、初诊时ECOG评分2~4分者预后较差;而性别、吸烟、骨转移部位、有无骨相关事件、骨以外的其他部位转移、血清ALK、CEA与OS无关。多因素分析显示,病理类型(OR=2.996,95%CI:1.070~8.389,P=0.037)、骨转移灶数目(OR=3.263,95%CI:1.083~9.827,P=0.036)为影响OS的独立因素。结论在以骨转移为首发表现的NSCLC中,病理类型、骨转移灶数目可能为影响患者远期生存的独立预后因素。
Objective To analyze the prognostic factors of patients with non-small cell lung cancer (NSCLC) that affect bone metastasis as the first manifestation. Methods The data of 46 NSCLC patients with bone metastasis diagnosed from Provincial Cancer Hospital Affiliated to Anhui Medical University and Anhui Cancer Hospital from August 2010 to August 2012 were retrospectively analyzed. The Kaplan-Meier method was used to analyze the clinicopathological features Age, sex, smoking, pathological type, the number of bone metastases, bone related events, other site metastasis, ECOG score, alkaline phosphatase and carcinoembryonic antigen) and overall survival (OS) Analysis of independent factors affecting patient OS. Results The median OS for all patients was 237 days. Univariate analysis showed that the pathological type, the number of bone metastases and the ECOG score at initial diagnosis were OS factors. The number of squamous cell carcinoma and bone metastasis was more than or equal to 2, and the prognosis of patients with ECOG score 2-4 was poor at the initial diagnosis. The gender, Smoking, bone metastases, presence or absence of bone-related events, metastases to other parts of the bone, serum ALK, CEA and OS unrelated. Multivariate analysis showed that the number of bone metastases (OR = 3.263, 95% CI: 1.083-9.827, P = 0.036) was the significant difference in pathological type (OR = 2.996,95% CI: 1.070-8.389, P = 0.037) Independent factors. Conclusion In NSCLC with bone metastasis as the first manifestation, the number of pathological types and the number of bone metastases may be an independent prognostic factor in the long-term survival of patients.