鼻咽癌骨转移核素显像分析

Radionuclide Imaging Analysis of Skeletal Metastases in Carcinoma of Nasophrarynx

目的：探讨鼻咽癌骨转移患者骨显像的特点及规律。方法：选择61例鼻咽癌患者做全身骨核素显像。结果：61例鼻咽癌患者中有39例骨显像异常，结合临床及X线诊断为骨转移，骨转移的发生率为63.9％，临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期的发生率分别是0、41．7％、57．7％、86．4％。39例骨转移患者中36例为多发病灶（占92．3％），3例为单发病灶（占7．7％）。骨转移的部位以脊柱为多见，其余依次为胸部、骨盆、肢体和颅骨。临床Ⅳ期或伴有远处其他器官转移的患者出现骨显像异常的可能显著增多（P＜0．05），骨转移是否发生与肿瘤原发病灶的范围及颈部淋巴结果及程度之间的关系未能得到统计学证实。43例放射治疗后骨显像患者中有36例（占83．7％）出现一例或双侧乳突部位放射性分布增多，其发生机理有待进一步探讨。结论：鼻咽癌骨转移发生率很高，与病程有一定关系，核素全身骨显像对于临床诊断分期及治疗有一定的意义，应作为各期鼻咽癌诊断的常规。

Objective:To evaluate the characteristics and regularity of skeletal metastses in carcinoma of nasophrarynx.Methods: 61 patients with carcnoma of nasophrarynx were examined by radionuclide bone imaging. Results: Among them, 39cases were identified as having skeletal metastass.The incidence of bone metastses compared with clinical data and X-ray examination was about 63.9% .The incidence of clinical Ⅰ. Ⅱ. Ⅲ and Ⅳ stages were 0,41.7%,57.7% and 86.4%, respectivel.Multiple metastatic lesions accounted for 92.3% (36 cases)and solitary 7.7%(3 cases)the average being 6.2 per patient.The site of bone metastases was more common in the spine, follwing orders were thorax, pelvis, limbs and skull. There was significant difference in incidence of bone metastases in the patients with clinical Ⅳ stage or other organs had metastases(P<0.05).There was no statistical significance in incidence of bone metastases in the patoents with the range of original tumour and the area of lymph node in the meck.Among 43 patients examined by radionuclide bone imaging after radiotherapy 36 cases (83.7%) had increased radioactivity in mastoided,and further study was required. Conclusion: Bone imaging should be performed in the patients with carcinoma of nasophrarynx,because it is of importance for evaluation of staging and therapy.