肺癌性骨关节病的临床分析

目的警惕肺癌性骨关节病，提高诊断准确率，争取早期诊断原发病，取得良好疗效，防止误诊、误治。方法对廊坊市人民医院2003年10月至2006年10月，诊治肺癌266例。部分病例首发症状为肺性关节病，确诊肺癌32例，进行回顾分析。结果手术切除原发肺癌病灶6例，术后骨关节病症消失，存活2—5年；其余病例失去手术机会，化疗16例，化疗合并放疗5例，其症状均明显好转，存活6～15个月。放弃治疗5例，症状未缓解，存活1～5个月。结论肺癌约12％首发症状为肺性骨关节病，发病至确诊最长时间15月，常误诊为肩周炎、颈椎病、棘上棘间韧带炎、风湿病或类风湿性关节炎、肢端肥大症等。对病因不明的骨性关节病，应列入肺癌排查程序。

Clinical analysis of the pulmonary bone diseases with 32 case reports

Objective Through the review and analysis, the pulmonary bone diseases should be on guard, the diagnostic accuracy is improved and the primary disease are given the early diagnosis. Methods 266 cases with the lung cancer from 2003 to 2006 in our hospital were reported. In some cases, the initial symptoms were the pulmonary joint diseases, 32 cases were diagnosed. Results The initial tumor of the lung there 6 patients were cut off , and the symptoms were released, and the living time was 2 - 5years. And the other patients had no chance to operate. 16 patients were treated with chemotheraphy ,and 5 patients were treated with chemotheraphy and radiotheraphy, then the symptoms of the 21 patients was released, and the living time was 6 - 15 months. 5 patients refused any treatment. , and the symptoms weren＇ t released, and furthermore the living time was 1 -5 years. Conclusions 12% initial symptoms of lung cancers were the pulmonary bone diseases, the longest time from onset to diagnosis was 15 months, also, the scapulohumeral periarthritis, the cervical disease, the supra- interspinous syndesmitis, the rheumatism or the rheumatoid arthritis are often misdiagnosed.