Abstract
OBJECTIVE: To investigate the risk factors of bone metastasis in lung adenocarcinoma and construct a risk prediction model. METHODS: Patients with newly diagnosed primary lung adenocarcinoma admitted to our hospital between 1 March 2018 and 1 March 2023 were retrospectively enrolled as the study participants. Finally, 273 patients were included in strict accordance with the inclusion and exclusion criteria and divided into a bone metastasis group (n = 123) and a non-bone metastasis group (n = 150) according to whether bone metastasis had occurred. The clinical data of all the study participants were collected and retrospectively analysed. RESULTS: Bone metastases were more common in the vertebrae, ribs and hip bones, followed by the scapula, femur, sternum and skull, but they were rare in the humerus, fibula and clavicle. The bone metastasis group exhibited more clinical symptoms than the non-bone metastasis group, including the presence of primary lung adenocarcinoma > 3 cm in diameter, and the differences were statistically significant (P < 0.05). The positive rate of EGFR gene mutation and CEA, CYFRA21-1 and ALP levels in the bone metastasis group were higher than those in the non-bone metastasis group, and the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that positive EGFR gene mutation (P < 0.001), CEA > 5 ng/mL (P < 0.001) and primary lung adenocarcinoma diameter > 3 cm (P = 0.003) were independent risk factors for bone metastasis in lung adenocarcinoma. A receiver operating characteristic curve was used to verify the predictive value of the regression model, and the area under the curve was 0.912 (P < 0.001). CONCLUSION: The most common sites of bone metastases in newly diagnosed lung adenocarcinoma are the spine and ribs. Positive EGFR gene mutation, CEA > 5 ng/mL and primary lung adenocarcinoma diameter > 3 cm are independent risk factors for bone metastasis in lung adenocarcinoma. CLINICAL TRIAL NUMBER: Not applicable.