贾莉 夏正武 马世兴

[摘要] 目的：探讨全身骨显像在诊断肺癌骨转移的临床价值，以便更好地指导肺癌患者的分期及治疗。方法：126例病理确诊为肺癌的患者均行全身骨显像、CT及碱性磷酸酶、血钙检查。统计肺癌患者不同病理类型、不同临床分期发生骨转移的几率，将全身骨显像与可疑骨转移临床因素（包括骨痛、碱性磷酸酶升高、高钙血症中任意一项或几项）诊断骨转移的准确性进行统计学比较。结果：肺癌骨转移的发生率为27.8%，周围型肺癌较中央型肺癌骨转移发生率高（P＜0.01），肺腺癌较肺鳞癌骨转移发生率高（P＜0.01），Ⅲ、Ⅳ期患者骨转移发生率明显高于Ⅰ、Ⅱ期的患者（P＜0.01）。全身骨显像诊断肺癌骨转移的灵敏度（94.3%）、特异性（84.6%）、准确性（87.3%）均高于可疑骨转移临床因素对骨转移的诊断。结论：肺癌患者应常规行全身骨显像，这对肺癌的分期、治疗有着重要的临床意义。

[关键词] 肺癌；全身骨显像；骨转移

[中图分类号] R734.2[文献标识码] B[文章编号]1673-7210（2011）11（c）-103-03

Clinical value of the whole body bone imaging in diagnosing bone metastasis from lung cancer

JIA Li1, XIA Zhengwu2, MA Shixing1

1.Department of Nuclear Medicine, Yunnan Provincal Cancer Hospital, Yunnan Province, Kunming 650118, China; 2.Department of Laboratory, Kunming General Hospital of PLA, Yunnan Province, Kunming 650032, China

[Abstract] Objective: To explore clinical value of the whole body bone imaging in diagnosing bone metastasis from lung cancer, in order to guide staging and treatment of patients with lung cancer. Methods: 126 patients with pathological diagnosis of lung cancer were performed whole body bone imaging, CT and ALP, blood calcium inspection. Probability of bone metastasis from lung cancer of the different pathological type and different clinical stage were counted. The whole body bone imaging and clinical factors of suspicious bone metastasis (including bone pain, alkaline phosphatase, high calcium levels, arbitrary or a few) for diagnosis accuracy of bone metastases were statistical compared. Results: The incidence of bone metastasis from lung cancer was 27.8%, and the bone metastases occurrence probability of peripheral lung cancer was higher than central lung cancer (P＜0.01), bone metastases occurrence probability of lung adenocarcinoma was higher than lung squamous cell carcinoma (P＜0.01),bone metastases occurrence probability of period Ⅲ, Ⅳ patients was obviously higher than that of period Ⅰ, Ⅱ (P＜0.01). The sensitivity (94.3%), specific degrees (84.6%), accuracy (87.3%) of the whole body bone imaging diagnosis of bone metastases from lung cancer were higher than the clinical factors of suspicious bone metastasis diagnosis of bone metastases. Conclusion: Whole body bone imaging should be a routine examination in patients with lung cancer. The clinical significance is important to determine stage and treatment of lung cancer.

[Key words] Lung cancer; Whole body bone imaging; Bone metastasis

肺癌是临床上常见的恶性肿瘤，20%～40%患者发生骨转移[1]，将严重影响患者的生活质量及生存期。早期发现骨转移对指导肺癌的临床治疗非常重要。本研究回顾165例病理确诊为肺癌患者的临床资料，探讨全身骨显像及可能发生骨转移的临床因素在诊断肺癌骨转移中的临床价值。

1 资料与方法

1.1 一般资料

2009年3～9月在我院经支纤镜取材，病理证实为肺癌的患者126例，均行全身骨显像、CT（胸部、腹部及头颅）及碱性磷酸酶、血钙检查，并随访1年以上。其中，男96例，女30例；……