Li Yang, Xu Chongqing, Yu Qiquan
Department of Thoracic Surgery, Long Hua Hospital, Shanghai University of Traditional Chinese Medicine Shanghai, China.
Department of Orthopaedics, Long Hua Hospital, Shanghai University of Traditional Chinese Medicine Shanghai, China.
Am J Transl Res. 2022 Sep 15;14(9):6696-6702. eCollection 2022.
Bone tissue is the most common metastatic location besides lung and liver. 30%~40% of patients with non-small cell lung cancer (NSCLC) will have bone metastasis (BM) in the development of the disease. This study aims to explore the relevant risk factors through multivariate analysis, in order to provide basis for the prevention of BM and bone related events of NSCLC.
We analyzed 152 patients, with 67 in BM group and 85 in non-BM group. The general clinical data and laboratory indicators (mainly coagulation function) of patients were compared through univariate and multivarijate analysis. Finally, the independent risk factors of BM in patients with NSCLC were screened out.
The results of univariate analysis show that thrombosis, clinical stage, tumor-node-metastasis (TNM) stage, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-Dimer (D-D), platelet (PLT) and alkaline phosphatase (AKP) are the risk factors of BM in patients with NSCLC (<0.05). Further multivariate logistic regression analysis suggests that the independent risk factors of BM in patients with NSCLC are clinical stage III-IV, TNM stage T1-T3, TNM stage N2-N3, FIB, APTT, D-D and AKP (<0.05).
Clinical stage III-IV, TNM stage T1-T3, TNM stage N2-N3, FIB, APTT, D-D and AKP are the independent risk factors of BM in patients with NSCLC. Meanwhile, patients with these risk factors should be screened in time, which is of great significance to prevent bone related events and relieve pain.
骨组织是除肺和肝外最常见的转移部位。30%~40%的非小细胞肺癌(NSCLC)患者在疾病发展过程中会发生骨转移(BM)。本研究旨在通过多因素分析探讨相关危险因素,为NSCLC骨转移及骨相关事件的预防提供依据。
分析152例患者,其中BM组67例,非BM组85例。通过单因素和多因素分析比较患者的一般临床资料和实验室指标(主要是凝血功能)。最终筛选出NSCLC患者发生BM的独立危险因素。
单因素分析结果显示,血栓形成、临床分期、肿瘤-淋巴结-转移(TNM)分期、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板(PLT)和碱性磷酸酶(AKP)是NSCLC患者发生BM的危险因素(P<0.05)。进一步的多因素logistic回归分析表明,NSCLC患者发生BM的独立危险因素为临床分期III-IV期、TNM分期T1-T3期、TNM分期N2-N3期、FIB、APTT、D-D和AKP(P<0.05)。
临床分期III-IV期、TNM分期T1-T3期、TNM分期N2-N3期、FIB、APTT、D-D和AKP是NSCLC患者发生BM的独立危险因素。同时,应及时筛查具有这些危险因素的患者,这对预防骨相关事件和缓解疼痛具有重要意义。