46例骨转移为首发表现的非小细胞肺癌的预后分析

摘要

Objective To analyze prognosis-related factors of the non-small lung cancer( NSCLC) patients with bone metasta-sis as an initial presentation. Methods In the retrospective study, 46 NSCLC patients with bone metastasis as an initial presentation from Anhui Provincial Hospital Affiliated to Anhui Medical University and Anhui Provincial Cancer Hospital between February 2010 and February 2012 were investigated. The Kaplan-Meier method was employed to evaluate survival. Then the median overall survival ( OS) was analyzed among different clinicopathological parameters, including age, sex, smoking, pathological type, the number of bone metastasis, bone related events, other parts of the transfer, ECOG score, alkaline phosphatase and carcinoembryonic antigen. The Cox multivariate analysis was used to evaluate the independent factors affecting survival of patients. Results The median OS of 46 NSCLC patients was 237 days. The univariate analysis showed that tumor subtype, number of bone metastasis and ECOG performance status were prognostic factors. Multivariate analysis showed that the independent predictors of OS were tumor subtype ( OR=2.996, 95%CI:1.070-8.389, P=0.037) and the number of bone metastasis( OR=3.263, 95%CI:1.083-9.827, P=0.036) . Conclusion Tumor subtype and the number of bone metastasis of NSCLC patients with bone metastasis as an initial presentation may be independ-ent prognosis predictors.%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KaplanMeier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。