结直肠癌骨转移的临床特点及治疗(附104例)

目的:探讨结直肠癌骨转移的临床特点,提高结直肠癌骨转移诊疗水平.方法:通过对中国医科大学附属盛京医院2012年1月1日至2015年1月1日收治的104例结直肠癌骨转移患者资料进行回顾性分析,分析其临床特征,绘制生存曲线,总结诊疗规律.结果:2012年1月1日至2015年1月1日期间我院共收治结直肠癌骨转移患者104例,占同期结直肠癌患者的10.0%(104/1 038),其中结肠癌骨转移38例,直肠癌骨转移66例.多发骨转移60例(57.7%),单发骨转移44例(42.3%),常见转移部位依次为腰椎(38.5%)、骶骨(32.7%)、胸椎(30.8%)、肋骨(26.9%)、四肢骨(19.2%)、肩胛骨(3.8%)、颌面骨(1.9%).共有74例患者合并有远处脏器转移(71.2%),≥2处者46例,肺脏42例,肝脏40例,腹膜后淋巴结14例,腹股沟淋巴结6例,肾上腺4例,脑2例.确诊骨转移的中位时间为(26.1±3.3)个月.从确诊骨转移之日算起,中位生存期为(22.5±4.0)个月.结论:结直肠癌骨转移患者多合并远处脏器转移;直肠癌比结肠癌更易发生骨转移.

Clinical features and treatment of 104 patients with bone metastases from colorectal cancer

Objective:To analyze the clinical characteristics,diagnosis and treatment of bone metastases of colorectal cancer and to improve the level of diagnosis and treatment.Methods:The 104 cases of colorectal cancer patients with bone metastasis in Shengjing Hospital Affiliated to China Medical University from January 1,2012 to January 1,2015 were retrospectively analyzed.The clinical characteristics were described and the survival curves were drawn.Results:Totally 104 patients with bone metastasis from colorectal cancer in Shengjing Hospital Affiliated to China Medical University from January 1,2012 to January 1,2015 accounted for 10.0% of patients with colorectal cancer in the same period.Among the 104 cases of colorectal cancer patients with bone metastasis,66 rectal cancer cases had bone metastasis,which was significantly higher than that of 33 colon cancer cases.Solitary bone metastasis occurred in 44 cases (42.3%) and multiple bone metastasis in 60 cases (57.7%).The most common metastatic sites included lumbar vertebra (38.5%),sacrum (32.7%),thoracic vertebra (30.8%) and the rib (26.9%),limb bone (19.2%),scapula (3.8%),maxillofacial bones (1.9%).A total of 74 patients had distant metastasis (71.2%),46 cases of which had more than two organs,and the common organs included lung metastases (42 cases),liver metastases (40 cases) and retroperitoneal lymph node metastasis (14 cases),inguinal lymph node metastasis (6 cases),adrenal metastases (4 cases) and brain metastases (2 cases).The median time to diagnosis of bone metastases was (26.1±3.3) months.From the date of diagnosis of bone metastasis,the median survival time was (22.5±4.0) months.Conclusion:Patients with bone metastasis from colorectal cancer often combine with other organs metastasis.Rectal cancer is more prone to bone metastases than colon cancer for the early diagnosis.