老年肺癌患者318例核素骨显像结果分析

Assessment of radionuclide bone imaging in 318 elderly patients with lung cancer

目的对不同病理类型老年肺癌患者的放射性核素骨显像结果进行分析,以探讨老年肺癌骨转移的特点和规律。方法对318例肺癌患者进行全身骨显像,表现为脊柱孤立性浓聚灶的35例加行断层显像。结果①318例肺癌患者核素骨显像示骨转移者74例,转移率23.3%。骨转移部位以胸部为最多见（58例）,其次为中轴骨（46例）,再者为骨盆、四肢骨、颅骨。胸部与中轴骨的转移率高于其他部位（P〈0.05）。②腺癌135例,鳞癌122例,其他61例,腺癌的骨转移率显著高于鳞癌（P〈0.001）。③112例行全身骨显像随访,随访期间19例出现骨转移。④病程1-3个月时发现骨转移的患者（52例）显著多于其他时间段（P〈0.001）。结论肺癌患者核素骨显像对肺癌分期、治疗方案选择及预后疗效评估均有重要的临床参考价值。

Objective To investigate the clinical value of radionuclide bone scanning for detecting bone metastasis in elderly patients with lung cancer. Methods All the elderly patients with lung cancer underwent planar whole-body scans after injection of^ 99mTc-MDP. To those 35 patients detected singular lesion in planar scans, SPECT imaging of the impaired spine was performed afterwards at the same day. Results （~）Skeletal metastases were verified in 74 patients （23.3%）. More metastases were detected in thoracic region and vertebral column （P〈0.05）. ②The incidence of bone metastasis was also varying with different histopathological types of cancer. The bone metastasis was more common in patients with adenocarcinoma （P 〈0.05）. ③Among 112 patients underwent more than twice of bone scans, 19 of them were detected skeletal metastases during that period of time. ④As for the period of disease, significantly more patients were verified skeletal metastases during their first 3 months. Conclusion Radionuclide bone imaging is significant for staging, selecting therapy methods and evaluating the prognosis of lung cancer.