肺癌脊柱骨转移的特点和规律的初步探讨

Analysis of the Bone Scan Characteristics of Vertebral Metastasis from Lung Cancer

目的 :探讨肺癌脊柱骨转移的特点和规律。资料和方法 :回顾性分析 190例病理证实为肺癌、核素骨显像诊断脊柱骨转移病例的骨显像表现。结果 :(1)肺癌转移好发部位是胸椎 ,其次是腰椎。腺癌、早期肺癌及病程短者胸椎转移率较高 ,晚期肺癌以腰椎转移为主 ;(2 )腺癌、晚期肺癌及病程长的患者椎体转移范围广 ,手术较未手术患者椎体转移数少 ;(3)病灶常呈圆形或类圆形 ;(4)肺癌常合并脊柱外骨转移 ,以胸部骨常见。结论 :肺癌患者尤其是腺癌 ,确诊后宜尽早作骨显像检查 ,并注意定期随访 ,以早期发现脊柱骨转移病变 ,早期治疗 。

Purpose: To analyse the characteristics of vertebral metastasis from lung cancer. Materials and Methods: The planar skeletal scintigraphy in 190 patients with lung cancer and vertebral metastasis were reviewed retrospectively. Results: (1) Thoracic vertebrae was more frequently involved than lumbar vertebrae, and occured more frequenty in adenocarcinoma、 early stage or after short course of lung cancer, but as the cancer advanced, incidence of lumbar vertebrae involvement increased; (2) the vertebrae involvement was correlated with the stage or the pathological type of the cancer, the number of metastatic vertebrae increased with the advanced lung cancer, and operation might reduce number of metastatic vertebrae (3) most of the foci were circle in shape; (4) Vertebral metastasis was usually accompanied by metastatic foci in other bone, especially in thoracic region. Conclusion: Lung cancer patients, especially those with adenocarcinoma, should be surveyed by skeletal scintigraphy as early as possible; periodical fllow up with scintigraphy was recommended in order to find the metastasis to spine and to improve the prognosis of patients.