Objective To evaluate the short-term efficacy and quality of life of primary hepatocellular carcinoma patients after radiotherapy and pregabalin treatment for neuropathic pain with bone metastasis. Methods 32 patients with primary hepatocellular carcinoma bone metastases were treated with radiotherapy combined with pregabalin treatment.Then, we prospectively studied the analgesic efficacy for neuropathic pain and quality of life, used the brief pain inventory and douleur neuropathique 4 questionnaire (DN4) to evaluate pain at baseline, one and two months after radiotherapy, assessed pain response using the international consensus endpoint definition of bone metastasis, and used European Organization for Research and Treatment of Cancer Research and Treatment Quality of Life Questionnaire (EORTC QLQ-C30) and bone metastasis module (QLQ-BM22) for quality of life assessment. Results One and two months after radiotherapy, the average DN4 score of neuropathic pain decreased, and the objective pain relief rates were 62.8% and 68.6%, respectively.The physical, emotional, social, and role functional scores of EORTC QLQ-C30 functional scale significantly increased in the first month after radiotherapy.Symptom scale of pain (P=0.015), insomnia (P=0.035), and loss of appetite (P=0.022) improved, and fatigue was aggravated (P < 0.05).Two months after radiotherapy, the mean overall health score and all functional scale scores significantly increased than those at baseline.The scores of all symptom scales decreased, except fatigue, constipation, and financial difficulties (P < 0.05).In addition, pain responders showed significant improvement in emotional function (P=0.025) and physical function (P=0.029) in the functional scale and in pain (P=0.014) and fatigue (P=0.035) in the symptom scale.The QLQ-BM22 score showed that the painful sites (P=0.021) and pain characteristics (P=0.04) of the responders significantly improved compared with those of nonresponders two months after radiotherapy. Conclusion Radiotherapy combined with pregabalin can relieve neuropathic pain caused by bone metastasis from primary hepatocellular carcinoma and greatly improve the quality of life, particularly in pain responders.

Objective To explore the clinical features and risk factors of preoperative anemia in patients with gastric cancer.Methods The clinical data of 218gastric cancer patients who received gastric cancer surgery in the Second Affiliated Hospital of Nanjing Medical University from January 2015 to December 2018 were retrospectively analyzed.Patients were divided into the anemia group(n = 84)and non-anemia group(n =134)based on hemoglobin levels.The gender,age,hypertension,diabetes,body mass index(BMI),carcinoembryonic antigen(CEA),cancer antigen 199(CA199),cancer antigen 724(CA724),tumor location,tumor size,clinical stage and lymph node metastasis were collected.The Logistic regression analysis was performed to analyze the risk factors of preoperative anemia in patients with gastric cancer.Results Among 218 patients with gastric cancer,the incidence of preoperative anemia was 38.53%,including 51 cases(60.7%)of mild anemia and 50 cases(59.5%)of normocytic anemia.There were no statistically signifi-cant differences in BMI,hypertension,diabetes,CEA,CA199,CA724,tumor location,and lymph node metastasis between the two groups(P>0.05),while there were statistically significant differences in the terms of gender,age,tumor size,and clinical stage be-tween the two groups(P<0.05).Multivariate Logistic regression analysis showed that gender(P = 0.002),age(P = 0.023),tumor size(P =0.001),and clinical stage(P =0.003)were independent risk factors for preoperative anemia in patients with gastric cancer.Conclusion Gender,age,tumor size and clinical stage are independent risk factors for preoperative anemia in patients with gastric canc-er,which is helpful for clinicians to take some intervention strategies for patients.

目的 探讨胃癌淋巴结转移风险预测模型的构建及评价.方法 回顾分析244例胃癌患者临床资料,根据是否发生淋巴结转移将患者分为转移组(n=171)和无转移组(n=73).采用Logistic回归分析胃癌淋巴结转移的危险因素,构建胃癌淋巴结转移的预测模型,采用受试者工作特征(ROC)曲线评价预测模型的价值.结果 Logistic回归分析发现,浸润深度、临床分期是胃癌淋巴结转移的独立危险因素(P<0.05).建立回归模型Logit(P)=-1.833+3.121×浸润深度(肌层)+2.799×浸润深度(穿透浆膜层)+5.468×临床分期,预测模型的ROC曲线下面积为0.958(95％CI:0.925～0.980,P<0.001),约登指数:0.815,cut-off值为0.715,敏感度和特异性分别为84.2％和97.3％.结论 浸润深度、临床分期是胃癌患者淋巴结转移的独立危险因素,该模型有助于临床预测胃癌患者是否发生淋巴结转移.

目的:探讨影响非小细胞肺癌骨转移的危险因素.方法:选取2015年至2019年在南京医科大学第二附属医院住院治疗的非小细胞肺癌患者207例[骨转移组(n=113)、无骨转移组(n=94)].检测血清CA125、CEA、NSE、CYFRA21-1、LDH和ALP的水平,记录年龄、性别、吸烟史、高血压、糖尿病、临床分期、肿瘤位置、组织学类型和淋巴结转移等因素.采用单因素和Logistic多因素回归分析筛选影响非小细胞肺癌患者骨转移的危险因素.结果:单因素分析结果发现两组临床分期、淋巴结转移、CA125、CEA、NSE、CYFRA21-1、LDH比较具有统计学差异(P<0.05);NSE、CYFRA21-1在腺癌和鳞状细胞癌血清中水平无统计学差异(P>0.05);Logistic多因素回归分析结果显示,临床分期、淋巴结转移和CA125是影响非小细胞肺癌患者骨转移的主要因素(P<0.01).结论:临床分期、淋巴结转移和CA125是影响非小细胞肺癌患者骨转移的独立危险因素,为临床早期治疗提供重要的指导意义.

目的 探讨肿瘤标志物联合ALP在非小细胞肺癌骨转移中的诊断价值.方法 选取非小细胞肺癌患者159例[骨转移组(n= 82)、无骨转移组(n =77)]和83例肺炎患者(肺炎组).检测血清CEA、CYFRA21-1和ALP的水平,记录年龄、性别等信息.采用Pearson相关分析评价各指标间的相关性.非小细胞肺癌患者骨转移的影响因素采用Logistic回归分析.采用受试者工作特征(ROC)曲线评价血清CEA、CYFRA21-1和ALP诊断非小细胞肺癌患者骨转移的价值.结果 本研究共纳入159例非小细胞肺癌患者,未发生骨转移77例,发生骨转移82例,骨转移发生率为51.6％,腺癌与鳞状细胞癌骨转移发生率比较,差异无统计学意义(P＞0.05).骨转移组CEA、CYFRA21-1和ALP的水平均高于非骨转移组和肺炎组(P＜0.05),非骨转移组血清CEA、CYFRA21-1和ALP的水平均高于肺炎组,差异有统计学意义(P＜0.05).ALP与CYFRA21-1、CEA呈正相关(r= 0.278,P＜0.01;r= 0.343,P＜0.01).Logistic 回归分析结果显示,CYFRA21-1、CEA 和 ALP 是 NSCLC 患者发生骨转移的危险因素.ROC曲线结果显示,CEA、CYFRA21-1和ALP联合诊断非小细胞肺癌患者骨转移的曲线下面积(AUC)为0.829,95％CI:0.761～0.884,约登指数为0.512,敏感度和特异性分别为72.0％和79.2％.结论 肿瘤标志物联合ALP在非小细胞肺癌患者骨转移的诊断中具有重要价值.