Tomita评分及修正版Tokuhashi评分标准在脊柱转移癌中的应用评价及影响转移癌预后的危险因素分析

Evaluation of Tomita Score and Modified Tokuhashi Score in Spinal Metastasis and Analysis of Risk Factors Influencing Prognosis of Metastatic Carcinoma

摘要: 目的：探讨Tomita评分及修正版Tokuhashi评分标准在脊柱转移癌中的应用评价及其影响转移癌预后的危险因素分析。方法：对116例在我院行手术治疗的脊柱转移癌患者的生存期进行随访，平均年龄52.78岁，平均随访20个月(6~49个月)，记录患者中位生存期及总生存期，采用中位生存时间及其95%可信区间(CI)，用log-rank检验进行中位生存期分析；采用Kaplan-Meier曲线进行生存期分析。结果：116例患者术后中位生存期为17.36个月，修正版Tokuhashi评分系统患者的中位生存期为17个月，OS为19.32个月，Tomita评分系统的中位生存期为16个月，OS为16个月，两者都提供了具有统计学意义的结果。结论：Tomita评分系统和修正版Tokuhashi评分系统能有效判断患者的预后，单因素分析显示：年龄、性别、原发肿瘤的位置及生长速度、术前运动状态都可影响患者生存期。而对于肿瘤在脊柱转移的部位与手术方式可能对于生存期没有影响。

Abstract: Objective: To evaluate the application of Tomita score and modified Tokuhashi score in spinal metastasis and to analyze risk factors influencing prognosis of metastatic carcinoma. Methods: 116 patients with spinal metastases were followed up, the average age was 52.78 years old, the average follow-up was 20 months (6~49 months). The median survival time and total survival time were recorded. The median survival time and 95% confidence interval (CI) were used. The log rank test was used to analyze the median survival time. The Kaplan-Meier curve was used to analyze the survival time. Results: The median survival time of 116 patients was 17.36 months, that of the modified Tokuhashi scoring system was 17 months, that of the OS was 19.32 months, that of the Tomita scoring system was 16 months, and that of the OS was 16 months, both of which provided statistically significant results. Conclusion: Tomita scoring system and modified Tokuhashi scoring system can effectively judge the prognosis of patients. Single factor analysis shows that: age, gender, location and growth speed of primary tumor, and preoperative movement state can affect the survival period of patients. However, the site and operation mode of spinal metastasis may not affect the survival.