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[鳞状细胞癌中恶性肿瘤相关性高钙血症的临床特征及预后因素]

[Clinical characteristics and prognostic factors of malignancy-associated hypercalcemia in squamous cell carcinoma].

作者信息

Zhang Su-jie, Hu Yi, Jiao Shun-chang, Liu Zhe-feng, Tao Hai-tao

机构信息

Department of Oncology, General Hospital of Chinese PLA, Beijing, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2012 Dec;34(6):585-9. doi: 10.3881/j.issn.1000-503X.2012.06.009.

Abstract

OBJECTIVE

To explore the clinical characteristics and prognostic factors of patients diagnosed with squamous cell carcinoma (SCC) and presented malignancy-associated hypercalcemia (MAH).

METHODS

We retrospectively analyzed the clinical data of 36 patients with biopsy-proven SCC and presented MAH who were treated at the our department from January 2001 to December 2010. The survival were analyzed using the Kaplan-Meier method and Cox analysis.

RESULTS

Among these 36 patients, the median blood calcium level was 2.94 mmol/L (2.77-4.87 mmol/L), and the median survival time was only 45 days (1-839 d). Log-rank test showed that central nervous system symptoms, bone metastasis, and hypercalcemia occurring over 160 days after cancer diagnosis were predictors for poor survival(p=0.003, P=0.049, P=0.005). In the COX proportional hazard model analysis, central nervous system symptoms and hypercalcemia occurring over 160 days after cancer diagnosis were independent prognostic factors for survival time (RR=5.721, P=0.000; RR=4.624, P=0.001).

CONCLUSIONS

Patients with squamous cell carcinoma (SCC) and presented MAH have poor prognosis. Central nervous system symptoms and hypercalcemia occurring over 160 days after cancer diagnosis are independent predictors of the prognosis.

摘要

目的

探讨诊断为鳞状细胞癌(SCC)并出现恶性肿瘤相关性高钙血症(MAH)患者的临床特征及预后因素。

方法

回顾性分析2001年1月至2010年12月在我科接受治疗的36例经活检证实为SCC并出现MAH患者的临床资料。采用Kaplan-Meier法和Cox分析进行生存分析。

结果

在这36例患者中,血钙水平中位数为2.94 mmol/L(2.77 - 4.87 mmol/L),中位生存时间仅为45天(1 - 839天)。Log-rank检验显示,中枢神经系统症状、骨转移以及癌症诊断后160天以上出现的高钙血症是生存预后不良的预测因素(p = 0.003,P = 0.049,P = 0.005)。在COX比例风险模型分析中,中枢神经系统症状以及癌症诊断后160天以上出现的高钙血症是生存时间的独立预后因素(RR = 5.721,P = 0.000;RR = 4.624,P = 0.001)。

结论

鳞状细胞癌(SCC)并出现MAH的患者预后较差。癌症诊断后160天以上出现的中枢神经系统症状和高钙血症是预后的独立预测因素。

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