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目的：分析影响以骨转移为首发表现的胃癌患者的预后因素。方法回顾性分析确诊的以骨转移为首发表现的64例胃癌患者的临床资料,Kaplan-meier法分析临床病理特征(性别、年龄、分化程度、骨转移灶数目、骨转移灶部位及是否有骨外转移、有无放疗、ECOG评分、骨相关事件、血清Ca2+和 ALP 以及肿瘤标志物 CEA 和 CA199)与总生存期( OS)的关系,同时采用多因素COX模型分析影响患者OS的独立因素。结果单因素分析显示分化程度、骨转移灶数目、骨转移灶部位以及是否有骨外转移、初诊时ECOG评分以及肿瘤标志物CEA和CA199与胃癌骨转移患者的预后有关(P<0．05)；而性别、年龄、有无放疗、有无骨相关事件、血清Ca2+和ALP与OS无相关性。多因素分析显示骨转移灶部位(OR=0．524,95% CI：0．275~0．996,P=0．049)、合并骨外转移(OR=2．343,95% CI：1．338~4．101,P=0．003)、初诊时ECOG评分(OR=2．914,95% CI：1．422~5．972,P=0．003)为影响 OS 的独立因素。全组患者中位生存期为6．13个月。结论在以骨转移为首发表现的胃癌中,骨转移灶部位及是否有骨外转移、初诊时ECOG评分可能为影响患者远期生存的独立预后因素。“,”Objective To analyze prognostic-related factors of 46 cases of gastric cancer with bone metastasis as aninitial presentation. Methods The retrospective study included 64 cases of gastric cancer with bone metastasis as an initial presentation. The Kaplan-meier was used to evaluate survival. The median overall survival( OS) was ana-lyzed among different clincal pathological parameters, including sex, age, differentiation degree, the number of bone metastases, bone metastasis site andother parts, radiotherapy or not, ECOG score, bone related events, serum calcium,alkaline phosphatase, the tumor markers carcinoembryonic antigen and carbohydrate antigen 199. The COX model was employed to analyze the independent factors of patients. Results The median OS of 64 gastric cancer patients was 6. 13 months. The single factor analysis showed that the degree of differentiation, the number of bone metastasis, bone metastasis site, extraosseous metastasis or not, ECOG score and the tumor markers CEA and CA199 were related to the prognosis of patients with gastric cancer ( P <0. 05 ) . The multivariate analysis showed that the independent factors of OS were bone metastasis(OR=0. 524, 95% CI:0. 275~0. 996, P=0. 049), ex-traosseous metastasis(OR =2. 343, P =0. 003,95% CI:1. 338 ~4. 101), the ECOG score(OR =2. 914,P =0. 003, 95% CI:1. 422~5. 972). Conclusion Bone metastasis site and extraosseous metastasis, ECOG score at first visit of gastric cancer with bone metastasis as an initial presentation may be the independent prognostic predic-tors with long-term survival.