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目的应用骨显像与骨型碱性磷酸酶(B-AKP)联合测定,对89Sr治疗乳腺癌骨转移疗效进行研究。方法乳腺癌骨转移患者73例,89Sr治疗前1周及治疗后半年内进行全身骨显像及B-AKP测定。①根据骨病灶数目骨显像分为0、1、2、3共4级,治疗前后病灶数目的变化采用配对t检验,骨显像各级别组间B-AKP比较采用t检验。②计算病灶的摄取比值(T/NT比值),其变化采用t检验。③治疗前后B-AKP的变化采用t检验。结果①治疗前骨转移病灶为1～36(8.6±7.4)个,共618个,治疗后0～34(3.8±6.7)个,共349个,明显减少(t=4.079,P<0.01)。②治疗前T/NT值为1.12～15.38(5.36±4.67),治疗后为1.28～16.52(3.17±2.95),降低显著(t=7.907,P<0.01)。③治疗前B-AKP为9.6～65.5(28.4±14.8)μg/L,治疗后为10.9～54.7(20.9±11.7)μg/L,降低显著(t=3.349,P<0.002)。④骨显像结合B-AKP联合评估,ECT显像5例假阳性与6例假阴性得到纠正。结论全身骨显像与B-AKP测定有一定的互补性。89Sr治疗后疗效监测应以骨显像与B-AKP测定结合进行,以准确评估疗效,指导临床治疗。
Objective To evaluate the efficacy of 89Sr in the treatment of bone metastasis of breast cancer by bone imaging and bone alkaline phosphatase (B-AKP). Methods 73 cases of breast cancer patients with bone metastases, 89Sr 1 week before treatment and within six months after treatment for bone imaging and B-AKP determination. ① According to the number of bone lesions, bone imaging was divided into 4 groups of 0, 1, 2 and 3. The changes of the number of lesions before and after treatment were analyzed by paired t-test. The B-AKP was compared between two groups by t-test. ② calculate the lesion uptake ratio (T / NT ratio), the changes using t test. ③ before and after treatment B-AKP changes using t test. Results ① The bone metastases ranged from 1 to 36 (8.6 ± 7.4), with a total of 618 before treatment. There were 349 (3.8 ± 6.7) months after treatment, with a significant decrease (t = 4.079, P <0.01). ② Before treatment, the T / NT value was 1.12 ~ 15.38 (5.36 ± 4.67), after treatment it was 1.28 ~ 16.52 (3.17 ± 2.95), with a significant decrease (t = 7.907, P <0.01). ③B-AKP was 9.6 ~ 65.5 (28.4 ± 14.8) μg / L before treatment and 10.9 ~ 54.7 (20.9 ± 11.7) μg / L after treatment, with a significant reduction (t = 3.349, P <0.002). ④ Bone imaging combined with B-AKP assessment, ECT imaging 5 cases of false positives and 6 cases of false negatives were corrected. Conclusion Bone imaging and B-AKP have certain complementarity. 89Sr after treatment efficacy monitoring should be combined with bone imaging and B-AKP determination to accurately assess the efficacy and guide clinical treatment.