摘要
背景与目的骨转移是肺癌最常见转移部位之一,可引起疼痛、病理性骨折等,严重影响患者生活质量。本研究拟探讨骨扫描、MRI、CT、X线对非小细胞肺癌(NSCLC)骨转移的诊断价值,骨转移的治疗及预后相关因素分析。方法回顾分析16年我组连续诊治的561例晚期NSCLC的骨扫描检查,并与MRI、CT、X线检查骨转移方法对比。结果561例骨扫描中阳性455例,155例经临床排除骨转移,300例经临床、MRI/CT/X线证实或病理等证实为骨转移,假阴性5例,共305例骨转移。骨扫描总敏感性为98.36%,特异性为39.45%,准确度为71.48%。305例骨转移患者中有症状者138例,无症状者144例(47.21%),未记载者23例。多因素回归分析显示:转移在周围扁骨,骨磷治疗,无症状为有益的预后因素(P<0.05)。结论骨扫描对于肺癌骨转移筛查具有肯定的临床价值。核素骨扫描可成为肺癌分期检查的筛查手段。骨扫描的不典型阳性病灶,可辅以CT或MRI检查。
Background and objective Bone metastasis is very common in lung cancer patients. Metastasis to ,spine can lead to paralysis and fracture, deteriorate the quality of patient＇s life. The objective of this study is to investigate the diagnostic values of bone scanning （NBS）, MRI, CT and X-ray examination to discover bone meastasis of lung cancer, and the therapy of bone metastasis and the prognostic factors. Methods About 561 consecutive NSCI.C cases were analyzed with NBS and compared with other radioiogical examinations （MRI, CT and X-ray）. Results Out of the 455 positive patients by NBS, 300 cases were confirmed to be with bone metastases by dynamic follow-up, MRI, CT and X-ray, and 5 cases were false negative. The sensitivity and specificity of NBS was 98. 36% and 39. 45% respectively. The accuracy of NBS was 71. 48%. Among the 305 patients with bone metastases, 23 patients had no records, 138 patients had bone pain, the incidence of asymptomatic bone metastasis was 47.21 0%. Multivariables analysis showed that asymptomatic bone metastasis, flat bone metastases, therapy with disodium pamidronate were significantly good prognostic factors, respectively （P〈0. 05）. Conclusion A whole body NBS examination is preferred for the staging of NSCI.C. NBS is necessary for patients with NSCI.C. In order to exclude the possible false positive or false negative diagnosis by NBS, CT or MRI could be selected according to the sites of lesions.
出处
《中国肺癌杂志》
CAS
2006年第4期357-361,共5页
Chinese Journal of Lung Cancer
关键词
非小细胞肺癌
CT
MRI
X线
骨扫描
预后
Non-small cell lung cancer Computed tomography Magnetic resonance imaging X-ray Bone scanning Prognosis
