Risk Factors Of Bone Metastasis In Non-Small Cell Lung Cancer

Objectives:Distant metastasis is the main cause of death in non-small cell lung cancer(NSCLC), and bone is one of the common sites of metastasis. This study aims to analyze the risk factors of bone metastasis in NSCLC.Methods:We retrospectively reviewed 852 NSCLC patients from May 2009 to October 2013 in guangxi medical university affiliated tumor bospital,of which 222 individualswith bone metastasis and 630 patients without distant metastasis, who were pathologically-confirmed NSCLC prior to surgery, radiotherapy and chemotherapy. We assessed the association between gender, age, somking history, pathological type, differentiation degree, serum CEA levels, ECOG score, tumor size, lymph node and bone metastasis.Results:1.Univariate analysis results suggested pathological type, differentiation degree, serum CEA level, ECOG score, tumor size, lymph node is associated with bone metastasis((p<0.05), and gender, age, smoking history was not associated with bone metastasis(p≥0.05).2. Pairwise comparison of pathological type, adenocarcinoma and squamous carcinoma of the difference was statistically significant (p < 0.05), adenocarcinoma may be associated with bone metastasis. Adenocarcinoma and large cell, other types, squamous carcinoma and large cell, other types, large cell and other types were no statistical significance (p≥0.05).3. The serum CEA level was statistically significant in the range of<5.2ng/ml、40-50ng/ml、50-60ng/ml、60-70ng/ml、80-90ng/ml、 ≥100ng/ml((p< 0.05), and the serum CEA level of 40-50ng/ml^ 50-60ng/ml、60-70ng/ml、80-90ng/ml、≥100ng/ml may be associated with bone metastasis. While serum CEA level in 5.2-10 ng/ml,10-20 ng/ml,20-30 ng/ml,30 to 40 ng/ml,70-80 ng/ml,90-100 ng/ml range difference was not statistically significant(p≥0.05).4. ROC curve analysis all patients serum CEA level, ROC curve area under 0.670 (P< 0.000,95% CI 0.626-0.713) and serum CEA level equal to 40ng/ml is predicting bone metastasis is more appropriate to the critical point,and its sensitivity was 66.4% and specificity was 63.6%.5. The analysis results of relationship between primary tumor size and bone metastasis showed that the T1, T3, T4 difference was statistically significant((p< 0.05), T3, T4 may be associated with bone metastasis, and T1 is associated with no distant metastasis, Tis and T2 difference were not statistically significant(p≥0.05).6.The analysis results of relationship between lymph node and bone metastasis showed that the N0, N1, N2 and N3 difference was statistically significant((p< 0.05), N2, N3 may be associated with bone metastasis, and NO,N1 was associated with no distant metastasis.7. Logistic regression analysis revealed adenocarcinoma, poorly differentiation, serum CEA level^ 40ng/ml, ECOG score> 2 points,lymph node metastasis N2-3 May be independent risk factors of NSCLC bone metastasis patients(p< 0.05).Conclusions:Adenocarcinoma, poorly differentiation, serum CEA level≥40ng/ml, ECOG score> 2 points, lymph node metastasis N2-3 May be independent risk factors of NSCLC bone metastasis patients, for clinical evaluation of the prognosis, timely intervention and provide basis for reasonable treatment scheme.