胃癌骨髓转移的血液学特征和治疗方式探讨

目的 探讨胃癌骨髓转移患者的临床病理特征、治疗及预后.方法 回顾性分析9例胃癌骨髓转移患者的临床资料,总结其临床特点、诊断和治疗方法.结果 9例患者的年龄为18~68岁,中位年龄为51岁,病理均为低分化腺癌.患者均伴有其他部位转移,常见淋巴结和骨转移.骨痛、非感染性发热、红细胞和血小板二系下降、碱性磷酸酶和(或)乳酸脱氢酶不同程度升高、外周血涂片可见幼稚细胞是胃癌骨髓转移的常见表现.胃癌骨髓转移患者的中位生存期为34 d(11~266 d).结论 胃癌骨髓转移患者的预后差,熟悉胃癌骨髓转移的临床特点有利于早期诊断.

Hematological characteristics and treatment strategy of bone marrow metastasis in gastric cancer

Objective To investigate the clinicopathologic feature, treatment strategies and prognosis of gastric can-cer patients with bone marrow metastasis. Method The clinical profile of 9 gastric cancer patients with bone marrow me-tastasis were analyzed retrospectively. The clinicopathological characteristics, diagnosis and treatment methods were sum-marized. Result The age of the 9 patients was 18-68 (median:51) and the histological types of all cases were poorly dif-ferentiated adenocarcinoma. Disseminated organ metastases were observed in all cases, and most were in distant lymph nodes and bone. Common clinical manifestations of bone marrow metastasis were bone pain, non-infective fever, de-crease of 2 indexes in hemogram, increase of alkaline phosphatase and lactate dehydrogenase, immature cells in peripher-al blood smears. The median overall survival time of the patients was 34 days (11-266 days). Conclusion The prognosis of gastric cancer patients with bone marrow metastasis was poor. An in-depth understanding of the clinical features of these rare metastases may help discover the metastasis in the early stage.