ECT骨显像和骨髓涂片在神经母细胞瘤骨转移中的临床应用

Clinical application of ECT bone imaging and bone marrow smear in bone metastasis of neuroblastoma

目的:探讨ECT骨显像和骨髓涂片在神经母细胞瘤骨转移的临床应用价值。方法:回顾性分析2011年10月至2018年10月我院收治的216例经病理组织、淋巴结或骨髓活检确诊为神经母细胞瘤患者的临床资料,收集同一时段内的ECT骨显像和骨髓涂片结果,分析两种方法在神经母细胞瘤骨转移的临床应用价值。结果:ECT骨显像阳性106例,ECT骨显像阴性110例,阳性率49.07%;骨髓涂片阳性84例,骨髓涂片阴性132例,阳性率38.89%。ECT骨显像阳性而骨髓涂片阴性组46例,占21.30%;ECT骨显像阴性而骨髓涂片阳性组24例,占11.11%;ECT骨显像及骨髓涂片均阳性组60例,ECT骨显像及骨髓涂片均阴性组86例,两种方法在诊断神经母细胞瘤患者有无骨转移的符合率为67.59%。在106例ECT骨显像阳性中骨髓涂片阳性有60例,骨髓转移阳性率为56.60%,说明ECT骨显像提示骨转移时已有56.60%患者发生骨髓转移。结论:ECT骨显像和骨髓涂片检查在神经母细胞瘤患者骨转移的临床分期、疗效和预后评估具有重要的临床意义,建议临床应同时行ECT骨显像和骨髓涂片检查,以提高神经母细胞瘤骨转移的检出率及准确率。

Objective:To investigate the clinical application value of ECT bone imaging and bone marrow smear in bone metastasis of neuroblastoma.Methods:We retrospectively analyzed the clinical data of 216 patients with neuroblastoma diagnosed by pathology,lymph node or bone marrow biopsy from October 2011 to October 2018,and collected their ECT bone imaging and bone marrow smear results in the same period,so that we could analyse the clinical application value of the two methods in bone metastasis of neuroblastoma.Results:Among the patients,106 cases were positive in ECT bone imaging,while 110 cases were negative results,and the positive rate was 49.07%.84 cases were positive in bone marrow smear,and 132 cases were negative results,and the positive rate was 38.89%.There were 46 cases with positive ECT bone imaging but negative for bone marrow smear,accounting for 21.30%.On the contrary,24 cases with negative ECT bone imaging but positive for bone marrow smear,accounted for 11.11%.There were 60 cases with both positive results and 86 cases with both negative results.The coincidence rate of the two methods in the diagnosis of bone metastases in patients with neuroblastoma was 67.59%.Among 106 cases of ECT bone imaging positive,60 cases were positive for bone marrow smear,and the positive rate of bone marrow metastasis was 56.60%,indicating that 56.60%of patients had bone marrow metastasis when ECT bone imaging showed bone metastasis.Conclusion:ECT bone imaging and bone marrow smear examination have important clinical significance in the clinical stage,efficacy and prognosis evaluation of bone metastasis in NB patients.It is recommended that ECT bone imaging and bone marrow smear should be performed simultaneously to improve the detection rate and accuracy in bone metastasis of neuroblastoma.