| Background :The lung cancer not only is the one of the most common cancer in the world, but also the first cancer related to mortality in malignancy cancer. Although lung cancer incidence and mortality is decreasing in developed countries,but in other areas, the incidence and mortality of lung cancer is still rising trend. Bone is one of primary sites in advanced non-small cell lung cancer.In recent years the rise of comprehensive treatment and improved of clinical detection method in cancer makes more and more prolong survival time in patients with malignant tumor, it maybe increased the proportion of patients with bone metastases. Non-small cell lung cancer patients with bone metastases occurs SREs, it maybe serious influence the patient’s quality of life. At present the research rarely discuss that between the clinical features of NSCLC patients with bone metastases is correlation. So build prediction model of NSCLC patients with bone metastases occur SREs is necessary.purpose:To explore clinical and prognosis factors for skeletal-related events(SREs) in nonsmall cell lung cancer(NSCLC) patients with bone metastases.Methods1. We were retrospectived analysis Clinical data of histology and cytology confirmed 383 patients in non-small cell lung cancer with bone metastases between April 2007 and January 2014 in the third affiliated hospital of the third military medical university.2. It used to screening for Emission Computed Tomography(ECT) for bone metastases.And then it must be confirmed for Computed Tomography(CT), Positron Emission Tomography(PET-CT), X-ray,Magnetic Resonance Imaging(MRI) or pathology.3. Collection of NSCLC patients with bone metastases of age, sex, smoking, pathological type, TNM stage and clinical data of bone metastases and so on.4. SPSS 19.0 statistical software was used to statistical analysis for data.Results:1. 178 of 383 patients SREs in NSCLC patients with bone metastases.The incidence was 46.5%.2. Univariate analysis showed that man,smoking history,non-adenocarcinoma, multiple bone metastases,never bisphosphonates(BPs) therapy and epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKIs) therapy more than women, never smoking history,adenocarcinoma, single bone metastases, BPs therapy and EGFR-TKIs therapy in patients with bone metastases are higher likely to have SREs.It was considered statistically significant(P<0.05).3. Multivariate analysis showed multiple bone metastases and no BPs therapy is independent risk factors for SREs.4. Median survival time was 14.5 months.1 year survival rate was 46.5%,and 2 years survival rate was 15.9%.5. The survival analysis shows that more BPs treatment and EGFR-TKIs with BPs therapy on the prognosis of patients with statistically significance(P<0.05).6. Between EGFR mutation status and SREs no statistical significance in NSCLC patients with bone metastases(P>0.05).Conclusions:1. It was likely to occur SREs in NSCLC patients with bone metastases.2. EGFR mutation status may has nothing to do with the SREs in NSCLC patients with bone metastases.3. No BPs and multiple bone metastases are independent risk factors for SREs. BPs may prevent or reduce SREs for NSCLC patients with bone metastases,and it may prolong survival, it speculated that BPs may have resistant NSCLC cell activity.Background :Because lung cancer may have no symptom in the early,lung cancer have invasive biological characteristics and the lack of early screening and early diagnosis, so it often has been advanced cancer patients at the time of diagnosis. In the past few decades, many scholars devoted to can study to the biochemical markers of bone metastases. A large number of studies have shown that bone turnover biochemical markers and bone metastases have close relations, the high-risk patients with bone metastases has important significance. There are all kinds of variability for bone turnover biochemical markers, according to the change of bone turnover biochemical markers,we are evaluation of drug curative effect in patients with NSCLC, We must be reasonable,plan to choose the best treatment plan, in order to achieve maximum incease survival, control over tumor progression and improve the quality of life of patients for the purpose. The bone biochemical markers was used only for scientific research.We have to explore the biological factors to predict how to bone metastases, it is worth further research.purpose:To explore biological and prognosis factors for skeletal-related events(SREs) in non-small cell lung cancer(NSCLC) patients with bone metastases.Methods1. To collect 101 cases the pathological specimens of surgically resected of NSCLC patients with bone metastases and non-bone metastases in the third military medical university the third affiliated hospital from May 2007 to November 2014.2. In NSCLC patients with bone metastases and non-bone metastases we were collected Clinical data of age, gender, smoking, TNM stage, pathological type and so on.3. It used to screening for ECT for bone metastases.And then it must be confirmed for CT, PET-CT, MRI or pathology.4. Immunohistochemistry were used to detect the expression of BSP and RANKL in primary NSCLC patients with bone metastases and non-bone metastases, and then IHC results were evaluated.5. SPSS 19.0 statistical software was used to statistical analysis for data.Results:1. In NSCLC patients with bone metastases BSP positive expression rate of 91.1% and 45.5% respectively, and the RANKL positive expression rate of 85.1% and 42.6% patients with non-bone metastases. The expression of BSP and RANKL protein has no statistical significance in NSCLC patients with or without bone metastases.2. The expression of BSP protein and RANKL protein maybe correlation in NSCLC bone metastases, and the BSP protein expression tend to be higher(P = 0.03).3. In NSCLC with bone metastases, the expression of BSP and RANKL protein and SREs may no statistical significance.4. The SREs had no obvious effect on OS In NSCLC with bone metastases(P= 0.173). The expression with BSP and RANKL protein and the OS has significant correlation(P < 0.05). In NSCLC without bone metastasis, and the expression with BSP and RANKL protein and OS are also statistically significant(P < 0.05).Conclusions:1. The expression of BSP and RANKL protein for bone metastases and SREs may be no effect.2. The expression of BSP and RANKL protein may have Synergistic effect... |
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