小细胞肺癌伴骨髓转移的临床分析

[Clinical Analysis of Small Cell Lung Cancer with Bone Marrow Metastases].

作者信息

Che Yiqun, Luo Yang, Wang Di, Shen Di, Yang Lin

机构信息

Department of Clinical Laboratory, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Department of Medical oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2018 May 20;21(5):403-407. doi: 10.3779/j.issn.1009-3419.2018.05.08.

DOI:10.3779/j.issn.1009-3419.2018.05.08

PMID:29764591

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5999923/

Abstract

BACKGROUND

Small cell lung cancer (SCLC) is highly malignant and prone to bone marrow metastasis in early stage, but its related reports are limited. This study analyzed the clinical feature, laboratory examination, treatment and prognosis of SCLC patients with bone marrow metastasis.

METHODS

The clinical data of 26 SCLC patients with bone marrow metastasis were analyzed retrospectively. Prognostic factors were evaluated.

RESULTS

The median age of 26 patients was 57 years and the median time from diagnosis of SCLC to confirmed bone marrow metastases was 8 d. Most patients (96.2%) were accompanied by other organ metastases. The most common laboratory abnormalities were elevated lactate dehydrogenase in 19 cases (73.1%), thrombocytopenia and elevated alkaline phosphatase respectively in 11 cases (42.3%) and anemia in 7 cases (26.9%). Twenty patients had received chemotherapy and the remaining 6 patients had not. Of this group, 16 patients received at least 2 cycles of chemotherapy after the diagnosis of bone marrow metastasis. The median survival time was 15.7 wk (0.1 wk-82.9 wk) after diagnosis of bone marrow metastasis. The survival of patients with chemotherapy was significantly better than that of those without chemotherapy (χ²=33.768, P<0.001). Multivariate analysis showed that no chemotherapy was independent poor prognostic factors (P<0.05).

CONCLUSIONS

The SCLC patients with bone marrow metastasis have short survival, whereas chemotherapy can extend the survival of patients.

摘要

背景

小细胞肺癌（SCLC）恶性程度高，早期易发生骨髓转移，但相关报道有限。本研究分析了发生骨髓转移的SCLC患者的临床特征、实验室检查、治疗及预后情况。

方法

回顾性分析26例发生骨髓转移的SCLC患者的临床资料，评估预后因素。

结果

26例患者的中位年龄为57岁，从SCLC诊断至确诊骨髓转移的中位时间为8天。大多数患者（96.2%）伴有其他器官转移。最常见的实验室异常为19例（73.1%）乳酸脱氢酶升高、11例（42.3%）血小板减少和碱性磷酸酶升高、7例（26.9%）贫血。20例患者接受过化疗，其余6例未接受化疗。在这组患者中，16例在诊断骨髓转移后接受了至少2个周期的化疗。骨髓转移诊断后的中位生存时间为15.7周（0.1周 - 82.9周）。接受化疗患者的生存情况明显优于未接受化疗的患者（χ² = 33.768，P < 0.001）。多因素分析显示未接受化疗是独立的不良预后因素（P < 0.05）。