【摘要】：目的:肝細胞肝癌骨轉移在我國的發(fā)病率不斷上升。本研究意在分析肝細胞肝癌骨轉移的臨床特征,影響預后的因素以及原發(fā)灶、轉移灶的不同治療方法對癌癥患者的影響。方法:本研究納入了浙江大學附屬第一醫(yī)院骨科自2010年1月至2014年12月期間診療的肝細胞肝癌骨轉移患者,回顧性分析其臨床特征,預后因素并比較了不同治療方式對患者的影響。結果:患者的平均年齡為54歲,共有38名男性和5名女性。軀干為最常見的轉移部位(74.0%),14名病人的骨轉移并發(fā)軟組織包塊(32.5%)。90.7%的骨轉移為溶骨成骨混合型,大部分骨轉移為多發(fā)性骨轉移(69.8%)。骨轉移診斷后的平均生存期為11月。多因素分析中,骨轉移后的生存期和Karnofsky功能評分(P=0.008),Child評分(P0.001)相關。肝細胞肝癌診斷至出現(xiàn)骨轉移的時間與UCSF評分(P0.001)以及原發(fā)灶的治療方式(P0.001)相關。肝移植患者較少地伴發(fā)了軟組織包塊。原發(fā)灶行肝移植及腫瘤切除的患者的肝內灶控制情況較保守治療患者好。結論:肝細胞肝癌骨轉移后影響患者生存期的獨立預后因素是Karnofsky功能評分和Child評分。肝細胞肝癌骨轉移患者能從先前的肝移植和腫瘤切除術獲益。
[Abstract]:Objective: the incidence of bone metastasis of hepatocellular carcinoma (HCC) in China is increasing. The purpose of this study was to analyze the clinical features of bone metastasis of hepatocellular carcinoma (HCC), the factors affecting prognosis and the influence of different treatment methods of primary tumor and metastatic foci on cancer patients. Methods: this study included patients with bone metastasis of hepatocellular carcinoma (HCC) from January 2010 to December 2014 in the Orthopaedics Department of the first affiliated Hospital of Zhejiang University. Prognostic factors and effects of different treatment methods on patients were compared. Results: the average age of the patients was 54 years old. There were 38 males and 5 females. Bone metastasis with soft tissue mass (32.5%). 90.7% of the bone metastases were mixed osteolytic osteoblasts, and most of the bone metastases were multiple bone metastases (69.8%). The average survival time after diagnosis of bone metastasis was 1 month. In multivariate analysis, survival time after bone metastasis was correlated with Karnofsky function score (P0. 008) and Child score (P0. 001). The time from diagnosis to bone metastasis was correlated with the UCSF score (P0.001) and the treatment of primary tumor (P0.001). Liver transplantation patients are less accompanied by soft tissue mass. Patients with primary liver transplantation and tumor resection had better intrahepatic focus control than conservatively treated patients. Conclusion: Karnofsky score and Child score are the independent prognostic factors influencing survival after bone metastasis of hepatocellular carcinoma. Patients with bone metastases from hepatocellular carcinoma can benefit from previous liver transplantation and tumor resection.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.7

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本文編號：2135217