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目的探讨肺癌骨转移的临床特点及早期观察骨显像在诊断肺癌骨转移中的临床价值。方法应用99mTc-MDP全身骨显像技术,分析1550例肺癌患者的临床资料和首次骨显像及病理检查结果。结果本实验观察1550例肺癌患者中,肺癌骨转移率为34.8%(540/1550),其中腺癌41.7%(365/876),鳞癌23.8%(114/478),未分化癌为37.1%(33/89),腺鳞癌26.1%(28/107)。本组460例(85.2%)为多发性明显的放射性浓聚,其余88例(16.3%)呈单发者均经MRI、CT及X线平片证实为骨转移。转移部位分别为:胸部骨68.7%,脊柱39.3%,骨盆32.5%,四肢骨17.8%,颅骨8.8%。结论肺癌患者早期进行99mTc-MDP全身骨显像,对病程分期、治疗方案的选择及预后的评价均有重要的临床意义;99mTc-MDP骨显像肺癌骨转移常见部位是胸部和脊柱,腺癌骨转移率最高。放射性核素骨显像对诊断肺癌骨转移有很高灵敏度。
Objective To investigate the clinical characteristics of bone metastasis of lung cancer and early observation of the clinical value of bone imaging in the diagnosis of bone metastasis of lung cancer. Methods 99mTc-MDP bone scintigraphy was used to analyze the clinical data and the results of the first bone imaging and pathological examination of 1550 lung cancer patients. Results Of the 1550 patients with lung cancer, the bone metastasis rate of lung cancer was 34.8% (540/1550), including 41.7% (365/876) for adenocarcinoma, 23.8% (114/478) for squamous cell carcinoma and 37.1% for undifferentiated carcinoma (33/89), adenosquamous carcinoma 26.1% (28/107). The group of 460 cases (85.2%) were multiple and significant radioactive accumulation, and the remaining 88 cases (16.3%) were single were confirmed by MRI, CT and X-ray film was bone metastasis. The metastatic sites were 68.7% for the chest, 39.3% for the spine, 32.5% for the pelvis, 17.8% for the extremities and 8.8% for the skull. Conclusions Early 99mTc-MDP whole body bone scintigraphy in patients with lung cancer has important clinical significance in the selection of course of disease, treatment options and prognosis. The common sites of 99mTc-MDP bone imaging of lung cancer with bone metastasis are chest and spine, adenocarcinoma The highest rate of bone metastases. Radionuclide bone imaging for the diagnosis of bone metastases of lung cancer have a high sensitivity.