分析老年肺癌骨转移患者临床病理特征及预后生存。

回顾性收集南京总医院收治的老年肺癌骨转移患者临床病理资料，记录并分析患者的性别、病理类型、肿瘤大体位置、吸烟史、原发病灶是否手术、碱性磷酸酶（ALP）水平、骨转移灶数目、是否放疗、是否化疗、TNM分期等指标。预后生存分析Log-rank进行单因素分析，对单因素分析有统计学意义的变量引入Cox比例风险回归模型进行多因素分析。

本研究共纳入91例老年肺癌骨转移患者，其中男性55例（60%），女性36例（40%）；病理类型腺癌49例（54%），鳞癌42例（46%）；肿瘤位于中央25例（27%），其余66例（73%）位于周边。本组老年肺癌骨转移平均生存时间为12个月，预后单因素显示病理类型（χ²=4.178，P=0.041）、原发病灶是否手术（χ²=7.980，P=0.005）、碱性磷酸酶（ALP）（χ²=6.814，P=0.009)、骨转移灶数目（χ²=13.592，P<0.001）和分期（χ²=10.060，P=0.018）与总生存期密切相关，Cox预后多因素发现ALP（HR=2.345，P=0.002）和骨转移灶数目（HR=1.987，P=0.001）为本组患者预后独立预后因素。

老年肺癌骨转移患者预后较差，ALP和骨转移灶数目可预测老年肺癌骨转移患者预后。

To analyze the features and prognosis of elderly patients lung cancer with bone metastases.

The clinical-pathological data of elderly patients lung cancer with bone metastases were retrospectively collected. Gender, pathological type, location of tumors, smoking status, the primary focus operation, the alkaline phosphatase (ALP), number of bone metastases, radiotherapy or chemotherapy status and TNM stage were recorded. The log-rank tests were performed to compare survival curves. Multivariate analyses were conducted to identify significant independent prognostic factors for the prognosis.

The average survival time of elderly patients lung cancer with bone metastases was 12 months. Univariate analysis showed significant relationships between the OS and the pathological type (χ²=4.178, P=0.041), the primary focus operation (χ²=7.980, P=0.005), the alkaline phosphatase (ALP) (χ²=6.814, P=0.009), the number of bone metastases (χ²=13.592, P<0.001) and the stages (χ²=10.060, P=0.018). Multivariate analysis results demonstrated ALP (HR=2.345, P=0.002) and the number of bone metastases (HR=1.987, P=0.001) were independent prognostic factors.

The prognosis of elderly lung cancer patients with bone metastases was poor, ALP and the number bone metastases can predict the prognosis.