肺癌指骨转移临床分析

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1、肺癌指骨转移临床分析肺癌以指骨转移为首发症状17例临床分析韩俊庆⑴韩春燕[2]毕迎惠[2]T晓⑵王兴文⑴盛巍⑴李冠桢⑴[1]250021济南山东省立医院肿瘤屮心；[2]250012济南山东大学医学院。[摘要]目的：探讨原发性肺癌以指骨转移为首发症状的临床特点及发生指骨转移的机理；方法：对1991年至2007隹期间有关文献报道的以指骨转移为首发症状的原发性肺癌患者的文献资料进行综合分析；结果：本文及文献报道的以指骨转移为首发症状的17例原发性肺癌患者屮，其转移病灶位于左手指骨者7例，右手指骨者9例，双手指骨者1例，指骨转移病灶的数量在两手之间

2、的分布大致相等，除3例患者其转移病灶位于指骨近节外，其余患者的转移病灶均位于其指骨末节；有6例病人的患病手指既往曾冇外伤史；结论：传统的机械•解剖学说和种子■上壤学说的观点均不能解释原发性肺癌发生指骨转移的机理，临床上如遇久治不愈的手指软组织炎症，应想到有肿瘤细胞转移至此的可能性。关键词：肺癌；首发症状；指骨转移；Theclinicalanalysisof17caseswithbronchogeniccarcinomaoffingersmetastasesasitsfirstsymptomHANJunqing[l],HANChunyan[2

3、],BlYinghui[2],DINGXiao[2]zWANGXingwen[l],SHENGWei[l],LIGuanzhen[l].DepartmentofOncology,ShandongProvincialHospital,Jinan250021；MedicineSchool,ShandongUniversity,Jinan250012,China.[Abstract]ObjectiveResearchtheclinicalcharacteristicsofprimarybronchogeniccarcinomawithmetast

4、asesofphalangesoffingersasitsfirstsymptomandthemechanismoftumormetastasistophalangesoffingers・MethodsLiteratureonprimarybronchogeniccarcinomawithmetastasesofphalangesoffingersasitsfirstsymptompublishedbetween1991and2005wasreviewed,andwassyntheticallyanalyzedcombiningwithth

5、eclinicaldataoftwosuchpatientstreatedinourhospital.Results16patientsreportedinthereviewedliteratureandthisarticlehadprimarybronchogeniccarcinomawithmetastasesofphalangesoffingersasitsfirstsymptom.7patients'metastaticlesionslocatedintheirphalangesoflefthands,8righthandsand1

6、bothhands・Thedistributionofthequantityofthephalangealmetastasesbetweentwohandswasalmostequal.3patients'metastaticlesionsweresituatedinproximalphalangesoffingers,andtherestindistal.6patients'illfingershadhadtraumahistory.ConclusionsNeitherthetraditionalmachine・anatomytheory

7、norseed・soiltheorycouldexplainthemechanismofprimarybronchogeniccarcinomametastasizingtophalangesoffingers,Ifpatientswithsofttissueinflammationoffingersthatcannotbehealedforalongtimeareencountered,thepossibilityoftumormetastasishereshouldbeconsidered・[KeyWords]bronchogenicc

8、arcinoma;firstsymptom;metastasesofphalangesoffingers.原发性肺癌骨转移是肺癌晩期常见的临床症状之一，文献报道其发生率约为50・