摘要
目的 探讨Tomita评分对脊柱转移癌患者中位生存时间的预测价值,并分析影响中位生存时间的相关因素。方法 选择2020年1月至2022年6月就诊并接受治疗的脊柱转移癌患者146例。收集患者一般资料、Tomita评分信息,随访18个月,统计患者生存情况。对比不同Tomita评分患者预后情况,并分析其对中位生存时间的预测价值。多因素logistic回归分析影响患者中位生存时间的相关因素。结果 不同性别患者年龄、原发肿瘤部位、转移癌病程、椎体受累数量、神经功能情况及Tomita评分比较差异均无统计学意义(P>0.05)。不同Tomita评分患者随访中位生存时间与Tomita量表提示生存时间基本相符;预期生存时间符合率分别为96.25%、89.58%和83.33%,且随着Tomita评分的降低呈减低趋势(P<0.05)。不同Tomita评分患者基线碱性磷酸酶(ALP)和Ca^(2+)水平均增高,且与Tomita评分变化趋势一致。依据Tomita评分给予相应治疗后,Tomita评分>8分组患者ALP和Ca^(2+)水平无变化(P>0.05),Tomita评分5~8分以及Tomita评分≤4分患者ALP和Ca^(2+)水平均有所减低,且Tomita评分≤4分组患者水平更低(P<0.05,P<0.01)。Tomita评分>8分组、Tomita评分5~8分组以及Tomita评分≤4分组生活质量评分呈现递减趋势(P<0.05)。年龄为脊柱转移癌患者生存时间是否<3个月或<12个月的保护因素,男性、原发肿瘤病程以及Tomita评分为危险因素,且脊柱转移癌病程是生存时间是否<3个月的危险因素(P<0.05)。结论 Tomita评分对于预测脊柱转移癌患者生存时间符合率较高。
Objective To explore the predictive value of Tomita score for the median survival time of patients with spinal metastatic carcinoma and to analyze the related factors influencing the median survival time.Methods A total of 146 patients with spinal metastatic carcinoma who visited the hospital and received treatment from January 2020 to June 2022 were selected.The general information of the patients and Tomita score information were collected,and they were followed up for 18 months to statistically analyze the survival status of the patients.The prognosis of patients with different Tomita scores were compared and its predictive value for the median survival time was analyzed.Multivariate logistic regression analysis was performed to identify the relevant factors affecting the median survival time of patients.Results There were no significant differences in patients with different with respect to age,primary tumor location,metastatic disease course,number of vertebrae involved,neurological function and Tomita score(P>0.05).The median survival time of patients with different Tomita scores during follow-up was basically consistent with the survival time indicated by the Tomita scale.The coincidence rates of expected survival time were 96.25%,89.58%and 83.33%respectively,and showed a decreasing trend with the decrease of Tomita score(P<0.05).Both the baseline alkaline phosphatase(ALP)and Ca^(2+)levels of the patients with different Tomita scores were elevated,and were consistent with the changing trend of the Tomita score.After corresponding treatments were given based on the Tomita score,there was no change in the ALP and Ca^(2+)levels of patients in the Tomita score>8 group(P>0.05).The levels of ALP and Ca^(2+)in patients with Tomita scores ranging from 5 to 8 and those with Tomita scores≤4 were both decreased,and the levels were even lower in the Tomita score≤4 group(P<0.05,P<0.01).The quality of life scores showed a decreasing trend in the Tomita score>8 group,the Tomita score 5-8 group and the Tomita score≤4 group(P<0.05).Age was a protective factor for the survival time(<3 months or<12 months)of patients with spinal metastatic carcinoma.Male gender,long course of primary tumor,and Tomita score were risk factors,and long course of spinal metastatic carcinoma was a risk factor for patients with survival time<3 months.Conclusion The Tomita score has a relatively high coincidence rate in predicting the survival time of patients with spinal metastatic carcinoma.
作者
任梦
董敏
黄春燕
沈莹
熊艳娟
REN Meng;DONG Min;HUANG Chunyan;SHEN Ying;XIONG Yanjuan(Department of Orthopedics and Hand Surgery,Liyuan Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China;Health Service Center of Yangchunhu Community,Wuhan 430000,China;Department of Geriatrics,Liyuan Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)
出处
《临床误诊误治》
2025年第15期32-37,共6页
Clinical Misdiagnosis & Mistherapy
基金
湖北省卫生健康委科研项目指导性项目(WJ2023F010)。
作者简介
任梦,本科。主要从事骨科学方向研究;通信作者:熊艳娟,Email:2436309123@qq.com。
