放射性核素骨显像诊断骨转移瘤的临床价值

Clinical value of radiation nuclide bone scan in diagnosis of metastatic bone tumor

目的对肺癌、乳腺癌、前列腺癌、鼻咽癌进行放射性核素骨显像,以观察不同脏器肿瘤骨转移的特点、发生率及转移部位。方法所有患者均进行全身骨显像,部分病例增加断层或特殊体位显像,显像剂为99mTc-亚甲基二膦酸盐(MDP)。结果(1)463例癌症患者核素骨显像示骨转移者197例,阳性率42.5%;(2)其中肺癌92例,骨转移36例,阳性率39.1%,乳腺癌151例,骨转移64例,阳性率42.4%,前列腺癌157例,骨转移75例,阳性率47.8%,鼻咽癌63例,骨转移22例,阳性率34.9%;(3)肺癌、乳腺癌、鼻咽癌骨转移部位以胸部为最多见,其次为脊柱,前列腺癌骨转移以骨盆为最多见,其次为脊柱;(4)肺癌骨转移在1a内发生率为43.2%,1a后则有所下降,而乳腺、前列腺癌、鼻咽癌在6个月后仍呈上升趋势。结论肺、乳腺、前列腺、鼻咽癌患者核素骨显像对病程分期、治疗方案选择及预后评估均有重要的临床参考价值。

Objective To observe the different features, rate of occurrence, diffusing parts of cancers of various organs through bone diffusing with nuclein bone scanning of lung cancer, breast cancer, prostate cancer and nasopharyngeal carcinoma. Methods All patients are performed with bone scanned, some of them added with faulted or special body position scanning, the developer is ^99mTc-MDP. Results （1）197 of the 463 patients bone scanned are bone diffusers, positive rate is 42.5%;（2）36 of the 92 cases of lung cancers are bone diffusers, positive rate is ,39.1%; of the 151 eases breast cancers, 64 cases are bone diffusers, positive rate is 42.4% ; of the 157 prostate cancers, 75 cases are bone diffusers, positive rate is 47.8% ; of the 63 nasopharyngeal carcinoma, 22 cases are bone diffusers, positive rate is 34.9% ;（3）the parts of bone diffusers of lung cancers and breast cancers happen frequently in the breasts, followed by spine; the parts of bone diffusers of prostate cancer often take place in bone basin, followed by spine; （4）the occurrence rate of bone diffusing for lung cancers is 43.2% in one year, but under one year the rate is dropping,however, the rate is raising after 6 months for breast cancer,prostate cancer and nasopharyngeal carcinoma. Conclusion The bone scan of the lung,breast, prostate,nasopharyngeal is very valuable clinically for the dividing stages of the course of disease, scheme of treatment and the evaluation to prognosis.