228例肺癌脑转移患者的临床观察#br#

目的探讨肺癌脑转移患者的临床及影像学特征。方法回顾性分析2014年1月至2016年12月江苏省肿瘤医院放疗科诊治的228例肺癌脑转移患者的临床资料。结果228例患者中男性140例，女性88例，中位年龄60岁，腺癌171例，小细胞癌35例，鳞癌22例。有脑转移症状者93例，无症状者135例。中位脑转移瘤确诊时间为5个月，890％患者在2年内确诊脑转移。1年内有、无颅外转移患者的中位脑转移瘤确诊时间分别为30个月和60个月，差异有统计学意义（P＜005）。脑实质转移227例，单纯幕上转移149例，单纯幕下转移15例，幕上、幕下均有转移63例。累及幕上者以顶叶（528％）和额叶（448％）最常见。原发灶不同病理类型的脑转移瘤单发及多发病灶分布情况的差异有统计学意义（P＜005）。结论肺癌确诊患者2年内脑转移高发，其中1年内发生其他脏器转移者的脑转移风险更高。肺癌脑转移瘤常多发，转移灶多位于幕上。

Clinical observation of 228 patients with brain metastases from lung cancer#br##br#

ObjectiveTo investigate the clinical and imaging features of lung cancer patients with brain metastases.MethodsThe clinical data of 228 lung cancer patients with brain metastases treated by radiotherapy department of Jiangsu cancer hospital from January 2014 to December 2016 were retrospectively analyzed.ResultsOf the 228 patients， 140 were males and 88 were females， with a median age of 60 years， 171 cases of adenocarcinoma， 35 cases of small cell carcinoma， and 22 cases of squamous cell carcinoma. There were 93 cases of brain metastases and 135 asymptomatic patients. The median time to diagnosis of metastatic brain tumors was 5 months， and 890％ patients were diagnosed with brain metastases within 2 years. The median time of diagnosis was 3 months and 6 months for patients with or without extracranial metastases. The difference was statistically significant （P＜005）. There were 227 cases of brain metastases， 149 cases of supratentorial metastasis， 15 cases of simple subtentorial metastasis， and 63 cases of supratentorial and subtentorial metastasis. The frontal（528％） and parietal（448％） lobes were the most common sites in the patients with supratentorial metastases. There were significant differences in the distribution of single and multiple foci in brain metastases of different pathological types （P＜005）.ConclusionBrain metastases are more frequent in patients with lung cancer within two years. The risk of brain metastases is higher in one year with other organ metastases. Brain metastases from lung cancer usually occur frequently， with metastases mostly on the supratentorial.