肺腺癌骨转移的危险因素
Risk factors of bone metastasis in lung adenocarcinoma.
作者信息
Cao Zhongnian, Zheng Rong, Li Jing, Wang Xuejuan, Ding Chao, Zhang Fan, Geng Jianhua, Wei Zhengmao, Fan Rong
机构信息
Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
Department of Anesthesiology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
BMC Pulm Med. 2025 Jul 2;25(1):299. doi: 10.1186/s12890-025-03702-0.
OBJECTIVE
To investigate the risk factors of bone metastasis in lung adenocarcinoma and construct a risk prediction model.
METHODS
Patients with newly diagnosed primary lung adenocarcinoma admitted to our hospital between 1 March 2018 and 1 March 2023 were retrospectively enrolled as the study participants. Finally, 273 patients were included in strict accordance with the inclusion and exclusion criteria and divided into a bone metastasis group (n = 123) and a non-bone metastasis group (n = 150) according to whether bone metastasis had occurred. The clinical data of all the study participants were collected and retrospectively analysed.
RESULTS
Bone metastases were more common in the vertebrae, ribs and hip bones, followed by the scapula, femur, sternum and skull, but they were rare in the humerus, fibula and clavicle. The bone metastasis group exhibited more clinical symptoms than the non-bone metastasis group, including the presence of primary lung adenocarcinoma > 3 cm in diameter, and the differences were statistically significant (P < 0.05). The positive rate of EGFR gene mutation and CEA, CYFRA21-1 and ALP levels in the bone metastasis group were higher than those in the non-bone metastasis group, and the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that positive EGFR gene mutation (P < 0.001), CEA > 5 ng/mL (P < 0.001) and primary lung adenocarcinoma diameter > 3 cm (P = 0.003) were independent risk factors for bone metastasis in lung adenocarcinoma. A receiver operating characteristic curve was used to verify the predictive value of the regression model, and the area under the curve was 0.912 (P < 0.001).
CONCLUSION
The most common sites of bone metastases in newly diagnosed lung adenocarcinoma are the spine and ribs. Positive EGFR gene mutation, CEA > 5 ng/mL and primary lung adenocarcinoma diameter > 3 cm are independent risk factors for bone metastasis in lung adenocarcinoma.
CLINICAL TRIAL NUMBER
Not applicable.
目的
探讨肺腺癌骨转移的危险因素并构建风险预测模型。
方法
回顾性纳入2018年3月1日至2023年3月1日在我院新诊断的原发性肺腺癌患者作为研究对象。最终，严格按照纳入和排除标准纳入273例患者，并根据是否发生骨转移分为骨转移组（n = 123）和非骨转移组（n = 150）。收集所有研究对象的临床资料并进行回顾性分析。
结果
骨转移在脊椎、肋骨和髋骨中更为常见，其次是肩胛骨、股骨、胸骨和颅骨，但在肱骨、腓骨和锁骨中较少见。骨转移组比非骨转移组表现出更多的临床症状，包括直径>3 cm的原发性肺腺癌，差异具有统计学意义（P < 0.05）。骨转移组EGFR基因突变阳性率及CEA、CYFRA21-1和ALP水平高于非骨转移组，差异具有统计学意义（P < 0.05）。多因素logistic回归分析显示，EGFR基因突变阳性（P < 0.001）、CEA>5 ng/mL（P < 0.001）和原发性肺腺癌直径>3 cm（P = 0.003）是肺腺癌骨转移的独立危险因素。采用受试者工作特征曲线验证回归模型的预测价值，曲线下面积为0.912（P < 0.001）。
结论
新诊断肺腺癌骨转移最常见的部位是脊柱和肋骨。EGFR基因突变阳性、CEA>5 ng/mL和原发性肺腺癌直径>3 cm是肺腺癌骨转移的独立危险因素。
临床试验编号
不适用。
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