摘要
目的通过回顾性分析国内多中心脊柱转移瘤病历资料,观察其流行病学特征。方法收集国内多个临床中心2007年1月至2019年6月的脊柱转移瘤患者,共纳入1976例脊柱转移瘤患者,其中男1129例(57.14%),女847例(42.86%),总体平均发病年龄为(58.6±11.6)岁(范围:13~92岁)。对其人口特征、原发肿瘤类型、脊柱受累节段和数目进行归纳总结,并通过查阅病历资料获得其临床指标,包括:Frankel分级、视觉模拟疼痛评分(visual analog scale,VAS)、转移性脊髓压迫症状(metastatic spinal cord compression,MSCC)、Tokuhashi修正评分、脊柱肿瘤不稳定评分(the spinal instability neoplastic score,SINS)、Karnofsky行为状态评分(Karnofsky performance status,KPS)及恶性肿瘤病史,最后对进行手术治疗的患者的干预影响因素进行统计学分析。结果1976例脊柱转移瘤患者男女比为1.33∶1,中位发病年龄为59.0岁,其中50~69岁为发病高峰(63.71%)。女性平均发病年龄小于男性,差异具有统计学意义。男性患者中60岁以上患者所占比例(53.23%)大于女性(47.80%),差异具有统计学意义。肺癌(730例,36.94%)为最常见的原发肿瘤,其次为未知来源肿瘤(326例,16.50%),乳腺癌(159例,8.05%),肾癌(120例,6.07%),消化道来源肿瘤(109例,5.52%)等。无论男女,肺癌均为最常见的原发肿瘤,男性其次为未知来源肿瘤,女性其次为乳腺癌。近10年来,未知来源肿瘤占比有减少趋势,乳腺癌占比有增多趋势。根据Tomita评分,快进展型肿瘤1284例(64.98%),中速进展型肿瘤211例(10.68%),慢进展型肿瘤481例(24.34%)。当患者受累椎体数<3个时,以腰椎转移(32.60%)最为常见,受累椎体数≥3个时,以跨节段转移(42.86%)最为常见。50.76%的患者出现了不同程度的脊髓损伤,77.18%出现中、重度的疼痛,14.02%出现转移性脊髓压迫症状,仅有28.95%的患者有明确的原发肿瘤既往史。治疗干预方面,34.92%的患者进行了手术治疗,5.97%
Objective To observe the epidemiological characteristics of spinal metastases by retrospectively analyzing the medical records of multicenter spinal metastases in China.Methods Patients with spinal metastases were identified from several clinical centers between January 2007 and July 2019.A total of 1976 patients were included in this study,including 1129 males(57.14%)and 847 females(42.86%).The mean age was 58.6±11.6 years(range 13-92 years).The demographic characteristics,primary tumor types,spinal involvement of each patient were summarized and their clinical indicators were obtained by consulting medical records,including:Frankel grade,visual analog scale(VAS),metastatic spinal cord compression(MSCC),Tokuhashi revised score,the spinal instability neoplastic score(SINS),Karnofsky performance status(KPS),and history of malignant tumors.Finally,the intervention influencing factors of patients undergoing surgical treatment were statistically analyzed.Results The ratio of male to female in 1976 spinal metastases was 1.33∶1.The median age was 59.0,and most patients(63.71%)were in the ages range of 50-69.The average age of female was younger than male,and the difference was statistically significant.The proportion of male patients over 60 years old was higher than females,and the difference was statistically significant.The most common primary tumor was lung cancer(n=730,36.94%),followed by unknown origin(n=326,16.50%),breast cancer(n=159,8.05%),kidney cancer(n=120,6.07%),gastrointestinal cancer(n=109,5.52%),etc.The most common primary tumor was lung cancer in both males and females,followed by unknown origin in males and breast cancer in females.In the past 10 years,the proportion of unknown origin has decreased,and the proportion of breast cancer has increased.According to the Tomita score,1284 patients(64.98%)were rapid growth tumors,211 patients(10.68%)were moderate growth tumors,and 481 patients(24.34%)were slow growth tumors.There were 730 patients(57.14%)in the subgroup of the number<3,the most level of wh
作者
张浩
杨立
李佶锴
乔睿琦
杨雄刚
张浩然
伦登兴
胡永成
Zhang Hao;Yang Li;Li Jikai;Qiao Ruiqi;Yang Xionggang;Zhang Haoran;Lun Dengxing;Hu Yongcheng(Department of Bone Tumor,Tianjin Hospital,Tianjin 300211,China;Graduate School,Tianjin Medical University,Tianjin 300070,China;Department of Spine Surgery,Weifang People's Hospital,Weifang 261000,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2020年第9期568-576,共9页
Chinese Journal of Orthopaedics
关键词
流行病学研究
肿瘤转移
人群监测
Epidemiologic studies
Neoplasm metastasis
Population surveillance
