本文選題：食管癌 + 轉(zhuǎn)移��； 參考：《北京協(xié)和醫(yī)學(xué)院》2015年碩士論文

【摘要】：背景目地：食管癌骨轉(zhuǎn)移的臨床規(guī)律研究較少,尤其對(duì)預(yù)后因素未作深入探討,查閱近40年來(lái)相關(guān)系統(tǒng)研究鮮有報(bào)道,本文旨在探討食管癌骨轉(zhuǎn)移患者的臨床特征及預(yù)后。研究方法：回顧性分析1981年3月1日至2012年12月30日中國(guó)醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院治療并全部接受骨掃描(ECT)檢查的食管癌患者1383例,符合篩選標(biāo)131例食管癌骨轉(zhuǎn)移患者的資料。全部采用門(mén)診復(fù)查和電話(huà)隨訪(fǎng),骨轉(zhuǎn)移后生存期計(jì)算自骨掃描診斷至死亡或末次隨訪(fǎng)的時(shí)間。統(tǒng)計(jì)學(xué)處理：采用SPSS17.0軟件,計(jì)數(shù)資料比較采用x2檢驗(yàn)或非參數(shù)檢驗(yàn)；生存分析采用Kaplan-Meier法；運(yùn)用Log-Rank檢驗(yàn)進(jìn)行生存曲線(xiàn)的比較,多因素分析采用Cox回歸模型,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果：食管癌骨轉(zhuǎn)移的發(fā)生率9.5%,從確診食管癌至骨轉(zhuǎn)移的中位時(shí)間為8.4個(gè)月,骨轉(zhuǎn)移后中位生存時(shí)間為6.6個(gè)月,1年生存率為26.2%。脊柱轉(zhuǎn)移率明顯高于其他骨轉(zhuǎn)移部位,其中尤以胸椎轉(zhuǎn)移率最高占23.4%,其次是骨盆49例(20.8%)、肋骨42例(18.2%)、腰椎36例(15.6%)。多發(fā)病灶82例(62.6%),單發(fā)病灶49例(37.4%)。食管癌不同原發(fā)部位之間在骨轉(zhuǎn)移部位的分布上無(wú)統(tǒng)計(jì)學(xué)差異,初診時(shí)有淋巴結(jié)轉(zhuǎn)移者骨盆轉(zhuǎn)移率高于無(wú)淋巴結(jié)轉(zhuǎn)移轉(zhuǎn)移者。單因素分析中,骨痛治療后緩解、骨轉(zhuǎn)移的治療、骨盆轉(zhuǎn)移與食管癌骨轉(zhuǎn)移患者的預(yù)后有關(guān)(均P0.05)。多因素分析中,骨轉(zhuǎn)移的治療、骨盆轉(zhuǎn)移是食管癌骨轉(zhuǎn)移患者預(yù)后的獨(dú)立因素。結(jié)論：食管癌骨轉(zhuǎn)移預(yù)后較差,骨盆轉(zhuǎn)移影響預(yù)后,放化療治療可能給患者帶來(lái)生存獲益。
[Abstract]:Background: there are few studies on the clinical characteristics of bone metastasis of esophageal carcinoma, especially on the prognostic factors. There are few reports on the related systematic studies in the past 40 years. The purpose of this article is to explore the clinical characteristics and prognosis of patients with esophageal cancer bone metastasis. Methods: 1383 patients with esophageal cancer treated by oncology hospital of Chinese Academy of Medical Sciences from March 1981 to December 30, 2012 were analyzed retrospectively. The survival time after bone metastasis was calculated from bone scan diagnosis to death or last follow-up. Statistical processing: using SPSS 17.0 software, counting data were compared by x2 test or non-parametric test, survival analysis by Kaplan-Meier method, Log-Rank test by comparison of survival curve, multivariate analysis by Cox regression model. P0.05 as the difference was statistically significant. Results: the incidence of bone metastasis of esophageal carcinoma was 9.5 months. The median survival time was 8.4 months, the median survival time was 6.6 months, and the 1-year survival rate was 26.2 months. The metastatic rate of spine was significantly higher than that of other bone metastases, especially in thoracic vertebrae, followed by pelvic 49 cases (20.8%), ribs in 42 cases (18.2%) and lumbar vertebrae in 36 cases (15.6%). Multiple lesions were found in 82 cases (62.6%) and single lesions in 49 cases (37.4%). There was no statistical difference in the distribution of bone metastases among different primary sites of esophageal cancer. The pelvic metastasis rate of patients with lymph node metastasis at first diagnosis was higher than that without lymph node metastasis. In univariate analysis, the prognosis of patients with esophageal cancer bone metastasis was related to the remission of bone pain, the treatment of bone metastasis and pelvic metastasis (P0.05). In multivariate analysis, the treatment of bone metastasis and pelvic metastasis are independent prognostic factors of esophageal cancer patients with bone metastasis. Conclusion: the prognosis of esophageal carcinoma with bone metastasis is poor and pelvic metastasis may affect the prognosis. Radiotherapy and chemotherapy may bring survival benefits to the patients.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R735.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張菁茹;王麗麗;高淑文;符妍;;75例大腸癌骨轉(zhuǎn)移預(yù)后影響因素的回顧性分析[J];安徽醫(yī)藥;2013年05期

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本文編號(hào)：2081953