^(99m)Tc-MDP骨显像在肺癌骨转移诊断中的临床意义

Clinical significance of ^(99m)Tc-MDP bone image in the diagnosis of lung cancer with osseous metastasis

目的探讨肺癌骨转移的临床特点及早期观察骨显像在诊断肺癌骨转移中的临床价值。方法应用99mTc-MDP全身骨显像技术,分析1550例肺癌患者的临床资料和首次骨显像及病理检查结果。结果本实验观察1550例肺癌患者中,肺癌骨转移率为34.8%(540/1550),其中腺癌41.7%(365/876),鳞癌23.8%(114/478),未分化癌为37.1%(33/89),腺鳞癌26.1%(28/107)。本组460例(85.2%)为多发性明显的放射性浓聚,其余88例(16.3%)呈单发者均经MRI、CT及X线平片证实为骨转移。转移部位分别为:胸部骨68.7%,脊柱39.3%,骨盆32.5%,四肢骨17.8%,颅骨8.8%。结论肺癌患者早期进行99mTc-MDP全身骨显像,对病程分期、治疗方案的选择及预后的评价均有重要的临床意义;99mTc-MDP骨显像肺癌骨转移常见部位是胸部和脊柱,腺癌骨转移率最高。放射性核素骨显像对诊断肺癌骨转移有很高灵敏度。

Objective To investigate the clinical characteristic of lung cancer with osseous metastasis and the clinical value of bone image in diagnosing the lung cancer with osseous metastasis in earlier period.Methods Analyse the clinical documents,the first bone image and the pathologic diagnosis of 1550 cases of lung cancer by 99mTc-MDP bone image.Results The incidence of lung cancer with osseous metastasis was 34.8%（54/1550）,and among them,adenocarcinoma was 41.7%（365/876）,squamous carcinoma was 23.8%（114/478）,anaplastic carcinoma was 37.1%（33/89）,adenosquamous carcinoma was 26.1%（28/107）.Analysis the bone images of 540 cases of lung cancer with osseous metastasis in final diagnosis,the bone images of 460 patients（85.2%）showed multiple radioactive focuses.The other 88 patients（16.3%） showed single radioactivity focuses which was confirmed by MRI,CT and X-ray.The site of osseous metastasis was 68.7% of costal bone,39.3% of spine,32.5% of basin,17.8% of limbs bone,8.8% of crinial bone.Conclusion The 99mTc-MDP bone images in earlier period of lung cancer with osseous metastasis is important for analysis of the course of the disease,the choices of treatment plan and the evaluation of prognosis.The 99mTc-MDP bone image shows the predilection site of lung cancer with osseous metastasis is costal bone and spine.The adenocarcinoma have the highest incidence rate of osseous metastasis.Radionuclide bone imaging have the high sensitivity for diagnosing the lung cancer with osseous metastasis.