| Objective:To investigate the incidence of bone metastasis in patients with hepatocellular Carcinoma(HCC)in Hainan area,to improve the understanding of the incidence of bone metastasis,and to analyze the risk factors of bone metastasis in HCC patients,so as to provide some theoretical basis for clinical differentiation,diagnosis and treatment.At the same time,we can set up the prediction model of the risk of bone metastasis in HCC patients.Methods: From January 2018 to December 2021,HCC patients in several hospitals and institutions in Hainan Province for the past four years(including the First Affiliated Hospital,Second Affiliated Hospital of Hainan Medical College,provincial and municipal hospitals)A total of 380 HCC patients were selected as the research subjects.The general clinical data of all patients were collected,and the patients were divided into a bone metastasis group and a non-bone metastasis group according to whether bone metastasis occurred during the diagnosis of HCC.The clinical characteristics of bone metastasis in HCC patients in Hainan Province were analyzed,and the risk factors for bone metastasis in HCC patients were analyzed by univariate and multivariate Logistic regression.Results:(1)A total of 380 HCC patients were included in this study,including 47 patients with bone metastases and 333 patients without bone metastases,and the incidence of bone metastases was 12.37%(47/380);(2)Among the 47 HCC patients with bone metastases,20 patients had single bone metastases,and 26 patients with multiple bone metastases had 1 patient with unclear bone metastases.There were 115 bone metastases in total,including 89 bone metastases in the trunk,14 bone metastases in the upper extremity,8 bone metastases in the lower extremity,and 4 bone metastases in the skull.Among the patients with HCC bone metastasis,trunk bone metastasis was more common,accounting for 77.39%(89/115),of which24.72%(22/89)of thoracic spine and 22.47%(20/89)of lumbar spine were more common,followed by ribs 20.22%(18/89);(3)gender(male/female),educational level(above junior high school/junior high school and below),permanent residence(rural/urban),marital status(already married/unmarried or divorced),body mass index(BMI),smoking history(yes/no),tea drinking(yes/no),drinking history(yes/no),presence of family history(yes/no),presence of liver cirrhosis(yes/no),antiviral history(yes/no),intrahepatic metastasis(yes/no),vascular tumor thrombus(yes/no),lymph node metastasis(yes/no),normal WBC(yes/no)No),HBs Ag(negative/positive and normal HGB(yes/no)and other general data,the difference was not statistically significant(P>0.05).5cm/≦5cm),number of tumors(multiple/single),extrahepatic metastasis(yes/no),ALP(<150/≧150),AFP(≧25/<25),normal PLT(yes/no),Compared with the data of CEA expression level and CA153 expression level,there were statistical differences(P<0.05);(4)Multivariate Logistic regression analysis showed that age,tumor size,tumor number,ALP,AFP,CEA expression levels and CA153 Expression level and other independent risk factors for bone metastasis in HCC patients(P<0.05);(5)The results of the nomogram model showed that the model consistency index(C-index)was 0.83(95%CI: 0.795-0.865);The calibration curve was basically consistent with the ideal curve;the area under the ROC curve(AUC)was 0.810(95%CI: 0.777~0.843).Conclusion: Trunk bone metastasis is more common in HCC patients in Hainan Province,accounting for 77.39%(89/115).The age,tumor size,tumor number,ALP,AFP,CEA and CA153 of HCC patients are all HCC patients.The independent risk factors for bone metastasis,the nomogram established based on the above seven risk factors can help predict the risk of bone metastasis in HCC patients. |
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