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目的：提高以风湿病症状为突出表现的恶性肿瘤的早期的识别，有利于提高临床医生对此类疾病早期诊断，避免误诊，提高诊断的正确率。方法：对22 例患者以骨骼、关节及肌肉疼痛为突出表现，拟诊风湿性疾病，最终确定诊断为恶性肿瘤患者的临床资料进行分析。结果：22 例患者中18 例属癌性风湿症，疼痛性质为隐痛，呈慢性反复渐进性加重，非甾体抗炎药和激素治疗的效果不佳，手术切除癌肿后，疼痛明显减轻；4 例患者属恶性肿瘤骨转移，最初为隐痛，逐渐发展为剧烈持续性疼痛，血沉有明显升高，抗核抗体（ANA）阳性，非甾体抗炎药和激素治疗效果为无效。结论：对骨骼、关节及肌肉疼痛的患者出现于风湿病难以解释的临床表现，常规治疗效果不佳，应注意排查恶性肿瘤的可能。

英文摘要:

Objective: To improve the understanding rheumatic symptoms associated with malignancies and reduce the rate of misdiagnosis. Methods: 22 patients of rheumatic symptoms with bone, joint and muscle pain for the outstanding performance, but eventually diagnosed as malignant, were investigated for clinical analysis. Results: There were 18 cases of cancerous rheumatism. Pain in the nature is dull pain, and chronic repeated progressive increase. These patients were poor response to the treatment of non-steroidal anti-rheumatic drugs and hormone therapy, but surgery may significantly reduce pain. There were 4 cases of rheumatic symptoms associated with bone metastasis. Pain in the nature is dull pain, and gradually developed into severe persistent pain. Erythrocyte sedimentation rate was significantly higher and anti-nuclear antibody (ANA) was posited. But these patients were poor response to the treatment of non-steroidal anti-rheumatic drugs and hormone therapy. Conclusion: We should pay attention to the diagnosis of rheumatic symptoms associated with malignancies, to patients who had unexplained the clinical performance of bone, joint and muscle pain and conventional treatment ineffective.

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