310例原发性肺癌核素骨显象的临床分析

The Clinical Analysis of Radionuclide Bone Imaging in 310 Cases of Primary Lung Cancer

目的 对原发性肺癌进行全身骨显象 ,结合病理诊断进行临床分析。方法 3 10例原发性肺癌均经病理确诊 ,男女之比为 3 5∶1,平均年龄为 5 1 5岁。静脉注射 99mTc -MDP( 2 0～ 3 0 )× 3 7MBq ,3小时后作全身骨显象。组间差异显著性用t及 χ2 检验。结果 原发性肺癌骨显象阳性率为 81 3 % ( 2 5 2 /3 10 )。按不同病理类型及细胞的分化程度 ,肺癌骨转移的频度依次为腺癌、鳞癌、混合型癌及小细胞癌 ,按电镜分型混合型居肺癌骨转移的首位 ,骨转移部位顺序依次为胸骨、脊椎、骨盆、四肢及颅骨。多发性转移 90 1%( 2 2 7/2 5 2 ) ,平均每例为 6 1个转移灶。结论 肺癌骨显象对临床TNM分期、治疗方案制订及预后判断至关重要 ,结合病理类型 ,特别是癌细胞分化程度及电镜分型更符合临床实际 ,可以解释肺癌的异常生物行为。

Objective We made clinical analysis of radionuclide whole-body bone imaging in 310 cases of primary lung cancer patients in combination with their pathological diagnose.Methods 310 cases of primary lung cancer patients were diagnosed according to pathological inspection. The whole-body bone imaging was performed 3 hours after the intravenous injection of 99 mTc-MDP(20～30) ×37 MBq. Significance difference between groups was done with t test and χ 2 test.Results The bone imaging positive rate in primary lung cancer patients is 81.3% (252/310). According to pathological type and cell differential degree, bone metastatic frequency is the highest in adenocarcinoma, lower in squamous cell carcinoma and mixed carcinoma, and the lowest in small cell carcinoma; according to electron microscopic type, mixed carcinoma stands first on the the list. The locality of bone metastasis occurs most often in breastbone, less in the backbone, pelvis and limbs,and least in the skull. The percent of multiple metastasis in patinets with bone metastasis if 90.1%(227/252) with a mean number of 6.1 metastatic foci.Conclusions Redionuclide inaging to lung cancer patients may be very useful in clinical TNM staging, formulating of treating plan and prognostic estimation of lung cancer patients. When combined with histopathological type, especially carcinoma cell differential degree and electron microscope type, it can make the clinical. TNM staging, formulation of treating plan and prognostic estimation more coincident with clinical practive and will aid in the accurate interpretation of abnormal biological behavior of lung cancer.