Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH

Objective:To review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer(CRPC)and examine the characteristics of equivocal bone scans that are associated with positive follow-up imaging.Methods:We identified 639 men from five Veterans Affairs Hospitals with a technetium-99m bone scan after CRPC diagnosis,of whom 99(15%)had equivocal scans.Men with equivocal scans were segregated into“high-risk”and“low-risk”subcategories based upon wording in the bone scan report.All follow-up imaging(bone scans,computed tomography[CT],magnetic resonance imaging[MRI],and X-rays)in the 3 months after the equivocal scan were reviewed.Variables were compared between patients with a positive vs.negative follow-up imaging after an equivocal bone scan.Results:Of 99 men with an equivocal bone scan,43(43%)received at least one follow-up imaging test,including 32/82(39%)with low-risk scans and 11/17(65%)with high-risk scans(p=0.052).Of follow-up tests,67%were negative,14%were equivocal,and 19%were positive.Among those who underwent follow-up imaging,3/32(9%)low-risk men had metastases vs.5/11(45%)high-risk men(p=0.015).Conclusion:While 19%of all men who received follow-up imaging had positive follow-up imaging,only 9%of those with a low-risk equivocal bone scan had metastases versus 45%of those with high-risk.These preliminary findings,if confirmed in larger studies,suggest follow-up imaging tests for low-risk equivocal scans can be delayed while high-risk equivocal scans should receive follow-up imaging.

^（153）Sm－EDTMP治疗骨转移癌疗效分析

报道经病理确诊的乳腺癌、鼻咽癌、肺癌等５１例骨转移患者行￣（１５３）Ｓｍ－ＥＤＴＭＰ内照射重复治疗的疗效。结果骨痛消失、减轻和无效分别为１７．６％、７４．５％和７．８％，总有效率为９２．１％。对１５例治疗前后全身骨显像作对比观察，其中７例病灶稳定，其余８例有１９个病灶消失或部分消失，同时２例出现新的骨转移灶。个别病例ＣＴ动态观察受累骨可见骨质修复，大多数患者全身状况改善，一过性白细胞降低、恶心仅占３．９％，无其他毒副作用。对￣（１５３）Ｓｍ－ＥＤＴＭＰ治疗骨转移癌过程中可能的影响因素作了分析。

全身骨显像联合血清血管内皮生长因子、糖类抗原153检测对乳腺癌骨转移的诊断价值

目的探讨全身骨显像联合血清血管内皮生长因子(VEGF)、糖类抗原153(CA153)检测对乳腺癌骨转移的诊断价值.方法选取110例乳腺癌患者,均进行全身骨显像及血清VEGF、CA153检测.根据骨转移情况将患者分为骨转移组(n=64)和非骨转移组(n=46).比较骨转移组和非骨转移组患者的血清VEGF、CA153水平,比较不同Soloway分级乳腺癌患者的血清VEGF、CA153水平,比较骨转移组和非骨转移组患者全身骨显像、VEGF、CA153阳性率,分析全身骨显像、VEGF、CA153单独及三者联合检测对乳腺癌骨转移的诊断价值.结果骨转移组患者的血清VEGF、CA153水平均明显高于非骨转移组,差异均有统计学意义(P﹤0.01).M3级患者的血清VEGF、CA153水平均高于M_(2)、M_(1)、M_(0)级患者,M_(2)级患者的血清VEGF、CA153水平均高于M_(1)、M_(0)级患者,M_(1)级患者的血清VEGF、CA153水平均高于M_(0)级患者,差异均有统计学意义(P﹤0.05).骨转移组患者全身骨显像、VEGF、CA153阳性率均明显高于非骨转移组,差异均有统计学意义(P﹤0.01).全身骨显像、VEGF、CA153联合检测诊断乳腺癌骨转移的灵敏度、特异度、准确度均高于单独检测.结论全身骨显像联合血清VEGF、CA153检测对乳腺癌骨转移具有较高的诊断效能,可为后续治疗提供参考依据.

分析全身成像与同位素骨扫描诊断乳腺癌骨转移

目的评价全身弥散加权成像与同位素骨扫描诊断乳腺癌骨转移结果。方法选取2013年7月—2014年7月我院收治的乳腺癌骨转移患者50例,采用同位素骨扫描诊断、全身弥漫加权成像,对比两种措施的检出率。结果经过调查,全身弥漫加权成像检出率高于同位素骨扫描诊断,组间对比差异具有统计学意义,P <0.05。结论在乳腺癌骨转移诊断的过程中,采用全身弥散加权成像诊断方式,能够预防辐射危害,增加检查范围,提升敏感性与检出率,具有较高的广泛应用优势。

血清脂蛋白a表达水平与原发性肺癌骨转移的关系

目的探讨原发性肺癌骨转移患者中血清脂蛋白a的表达水平,为原发性肺癌骨转移的诊断和治疗提供新的思路和依据。方法选取2017年10月至2022年10月间400例就诊于广州医科大学附属第五医院原发性肺癌患者作为研究对象。其中280例为原发性肺癌骨转移组,包括男性200例和女性80例,年龄范围在28~85岁;其余120例为原发性肺癌无骨转移组,包括90名男性和30名女性,年龄范围在29~88岁。所有骨转移患者均接受了骨扫描及磁共振成像(MRI)检查。收集这些患者的临床一般资料,测定纳入患者血浆中血清脂蛋白a的表达水平。结果原发性肺癌患者中,有骨转移和无骨转移患者在性别分布、吸烟史和饮酒史方面差异无统计学意义(均P>0.05),原发性肺癌骨转移患者血清脂蛋白a的表达水平较非骨转移患者明显升高(P<0.05)。结论原发性肺癌骨转移患者的血清脂蛋白a表达水平明显高于非骨转移组,这可能为原发性肺癌骨转移的诊断和治疗提供新的思路和依据。