Bone metastasis in gastric cancer patients.
Bone metastasis in gastric cancer patients.
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DOI：
10.5230/jgc.2011.11.1.38
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发表时间：
2011-03
影响因子：
2.5
通讯作者：
Kwon SJ
中科院分区：
文献类型：
--
作者：
Ahn JB;Ha TK;Kwon SJ
胃癌骨转移很少发生，而且预后很差。本研究探讨胃癌合并骨转移患者的临床特点及预后。研究对象为1992年6月至2010年8月在汉阳大学医学中心诊断为胃癌并伴有骨转移的19例患者。回顾性分析多种临床病理因素的生存率。18例接受手术的患者中有11例（61%）处于IV期，最常见的骨转移部位是脊柱。骨显像多用于诊断骨转移，PET-CT与磁共振成像可单独或联合使用。12例确诊时血清碱性磷酸酶增高，16例出现临床症状（骨痛）。治疗14例，以放射治疗为主。在诊断胃癌时发现骨转移2例。18例胃癌手术患者，术后至确诊骨转移时间平均为14.9±17.3个月，确诊骨转移至死亡时间平均为3.8±2.6个月。单因素生存率分析结果显示，骨转移治疗组在单发而非多发骨转移情况下的生存期明显优于未治疗组，但在多因素生存分析中，这两个因素都不是独立的预后因素。胃癌患者需要在初步诊断后和手术后进行放射性示踪试验，以确认骨转移的状态，骨显像是最有帮助的方式。早期诊断和适当的治疗有望提高生存率，甚至改善骨转移患者的生活质量。
Bone metastasis from stomach cancer occurs only rarely and it is known to have a very poor prognosis. This study examined the clinical characteristics and prognosis of patients who were diagnosed with stomach cancer and bone metastasis. The subjects were 19 patients who were diagnosed with stomach cancer at Hanyang University Medical Center from June 1992 to August 2010 and they also had bone metastasis. The survival rate according to many clinicopathologic factors was retrospectively analyzed. 11 patients out of 18 patients (61%) who received an operation were in stage IV and the most common bone metastasis location was the spine. Bone scintigraphy was mostly used for diagnosing bone metastasis and PET-CT and magnetic resonance imaging were used singly or together. The serum alkaline phosphatase at the time of diagnosis had increased in 12 cases and there were clinical symptoms (bone pain) in 16 cases. Treatment was given to 14 cases and it was mostly radiotherapy. There were 2 cases of discovering bone metastasis at the time of diagnosing stomach cancer. The interval after operation to the time of diagnosing bone metastasis for the 18 cases that received a stomach cancer operation was on average 14.9±17.3 months and the period until death after the diagnosis of bone metastasis was on average 3.8±2.6 months. As a result of univariate survival rate analysis, the group that was treated for bone metastasis had a significantly better survival period when the bone metastasis was singular rather than multiple, as compared to the non-treatment group, yet both factors were not independent prognosis factors on multivariate survival analysis. An examination to confirm the status of bone metastasis when conducting a radio-tracer test after the initial diagnosis and also after an operation is needed for stomach cancer patients, and bone scintigraphy is the most helpfully modality. Making the diagnosis at the early stage and suitable treatments are expected to enhance the survival rate and improve the quality of life even for the patients with bone metastasis.