| Yu Huang,Ping Peng,Peng Zhang,Lei Zhou,Yingying Wu. Analyses of the clinical characteristics of 49 cases of malignancy with multiple bone lesions as the first manifestation. Oncol Transl Med, 2021, 7: 83-87. |
| 以多发骨质破坏为首发表现的恶性肿瘤49例临床特点分析 |
| Analyses of the clinical characteristics of 49 cases of malignancy with multiple bone lesions as the first manifestation |
| Received:January 17, 2021 Revised:April 27, 2021 |
| DOI：10.1007/s10330-021-0479-9 |
| 中文关键词: 骨质破坏，恶性肿瘤，骨转移，临床特点 |
| 英文关键词: Bone lesions, malignancy, bone metastasis, clinical characteristics |
| 基金项目: |
| Author Name | Affiliation | Postcode | | Yu Huang | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | 430030 | | Ping Peng | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Peng Zhang | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Lei Zhou | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Yingying Wu* | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | 430030 |
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| 中文摘要: |
| 目的：分析以多发骨质破坏为首发表现的恶性肿瘤患者的临床资料，探讨该类疾病的临床特点。
方法：回顾性分析了我科2018年5月-2019年7月收治的以多发骨质破坏为首发表现的病例49例，所有患者均以“骨破坏部位疼痛”为主诉症状就诊，检查提示多发骨质破坏，考虑肿瘤性病变。收集患者年龄、性别、骨病变部位、病因、确诊方式、发病时间、影像学检查手段等信息。
结果：患者中位年龄为56岁，50岁及以上患者占比83.7%（41/49）。患者的中位发病时间为2月。40例患者证实为实体瘤骨转移,9例证实为血液系统肿瘤。肺癌和多发性骨髓瘤是主要的肿瘤类型，分别占40.8%（20/49）和16.3% (8/49)。而肺癌最常见的病理类型为肺腺癌（13例）。其他常见的病因分别为：消化系统来源7例（肝癌3例，胃癌*3例，食管癌*1例）；原发灶不明癌转移7例。实体瘤中50%（20/40）的患者仅存在多发骨转移而无其他远处部位转移。最常见的骨质破坏部位为胸椎、腰椎、肋骨、骨盆。
结论：多发性骨质破坏伴疼痛在多种恶性肿瘤中可能作为首发的临床表现被发现，常见的肿瘤类型依次为：肺癌、多发性骨髓瘤、消化系统肿瘤。多发骨质破坏可发生在不同年龄，但常见于50岁以上患者。多发性骨转移常常作为实体瘤的唯一远处转移部位，其具体机制还需要进一步探讨。 |
| 英文摘要: |
| Objective To investigate the clinical features of several cases of malignancy with multiple bone lesions
as the first manifestation.
Methods Forty-nine cases of malignancy with multiple bone lesions as the first manifestation were
retrospectively analyzed from May 2018 to July 2019. All patients complained of “pain at the site of bone
lesion” upon admission. Baseline patient information, such as age, gender, location of bone lesions,
etiology, diagnosis method, time of onset was collected.
Results The median age of the patients was 56 years old, of which 83.7% (41/49) were aged ≥50
years. The median time of onset was 2 months. Among the cases, 40 were confirmed as solid tumor bone
metastasis, whereas the remaining 9 cases as hematological system tumor. Lung cancer and multiple
myeloma were the main tumor types, accounting for 40.8% (20/49) and 16.3% (8/49), respectively. Other
common causes were seven cases of cancer affecting the digestive system (three cases of liver cancer,
three cases of gastric cancer, and one case of esophageal cancer), as well as seven cases of unknown
primary cancer. Half of the solid tumors had only multiple bone metastases but no other distant metastasis.
Conclusion Multiple bone lesions accompanied by pain may be the first clinical manifestation in various
malignant tumors. The common tumor types were lung cancer, multiple myeloma, and digestive system
tumor. It is more common in people aged 50 years and older. Multiple bone lesions might be the only
metastasis site of some solid tumors, and its mechanism needs further investigation |
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