Lim Jung Sub, Kim Sang Bum, Bang Ho-Yoon, Cheon Gi Jeong, Lee Jong-Inn
Department of Surgery, Korea Cancer Center Hospital, Gongneung-dong 215, Nowon-gu, Seoul 139-706, Korea.
World J Gastroenterol. 2007 Dec 28;13(48):6492-7. doi: 10.3748/wjg.v13.i48.6492.
To evaluate the prevalence and predictive factors of osteoporosis in patients with gastric adenocarcinoma after gastrectomy.
The study included 133 patients diagnosed with gastric adenocarcinoma but who did not undergo prior diagnostic work-up for osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) and vertebral deformity was assessed by plain X-rays. We evaluated the effects of age, sex, body mass index (BMI), anemia, back pain, vertebral deformity, tumor staging, reconstruction type, and past medical history to determine predictive factors of osteoporosis in these patients.
The prevalence of osteoporosis in the lumbar spine was 38.3% (male, 28.9%; female, 54.0%), and 15.0% in the femoral neck (male, 10.8%; female, 22.0%). The vertebral deformity rate was 46.6% (male, 43.4%; female, 52.0%). Age, BMI and hemoglobin correlated with BMD (P < 0.01). In males, anemia and age > 64 years were independent predictive factors of osteoporosis in multivariate analysis. In females, back pain was an independent factor for osteoporosis.
The results of this study revealed that prevalence of osteoporosis and vertebral bone deformity rate were high in gastric cancer patients, regardless of post-gastrectomy duration and operation type. Early diagnosis and a proper management plan must be established in these patients.
评估胃腺癌患者胃切除术后骨质疏松的患病率及预测因素。
本研究纳入133例已诊断为胃腺癌但未进行过骨质疏松诊断性检查的患者。采用双能X线吸收法(DXA)测量骨密度(BMD),通过普通X线评估椎体畸形情况。我们评估了年龄、性别、体重指数(BMI)、贫血、背痛、椎体畸形、肿瘤分期、重建类型及既往病史对确定这些患者骨质疏松预测因素的影响。
腰椎骨质疏松患病率为38.3%(男性为28.9%,女性为54.0%),股骨颈骨质疏松患病率为15.0%(男性为10.8%,女性为22.0%)。椎体畸形率为46.6%(男性为43.4%,女性为52.0%)。年龄、BMI和血红蛋白与BMD相关(P<0.01)。在男性中,多因素分析显示贫血和年龄>64岁是骨质疏松的独立预测因素。在女性中,背痛是骨质疏松的独立因素。
本研究结果表明,无论胃切除术后时间及手术方式如何,胃癌患者骨质疏松患病率及椎体骨畸形率均较高。必须对这些患者进行早期诊断并制定适当的管理计划。