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1、全身骨顯像診斷肺癌骨轉(zhuǎn)移臨床價(jià)值［摘要］目的：探討全身骨顯像在診斷肺癌骨轉(zhuǎn)移的臨床價(jià)值，以便更好地指導(dǎo)肺癌患者的分期及治療。方法：126例病理確診為肺癌的患者均行全身骨顯像、CT及堿性磷酸酶、血鈣檢查。統(tǒng)計(jì)肺癌患者不同病理類型、不同臨床分期發(fā)生骨轉(zhuǎn)移的幾率，將全身骨顯像與可疑骨轉(zhuǎn)移臨床因素(包括骨痛、堿性磷酸酶升高、高鈣血癥中任意一項(xiàng)或幾項(xiàng))診斷骨轉(zhuǎn)移的準(zhǔn)確性進(jìn)行統(tǒng)計(jì)學(xué)比較。結(jié)果：肺癌骨轉(zhuǎn)移的發(fā)生率為27.8%,周圍型肺癌較中央型肺癌骨轉(zhuǎn)移發(fā)生率高(P<0.01),肺腺癌較肺鱗癌骨轉(zhuǎn)移發(fā)生率高(PV0.01),III、IV期患者骨轉(zhuǎn)移發(fā)生率明顯高于I、II期的患者(P<0.01)o全身骨顯像診
2、斷肺癌骨轉(zhuǎn)移的靈敏度(94.3%)、特異性(84.6%)、準(zhǔn)確性(87.3%)均高于可疑骨轉(zhuǎn)移臨床因素對(duì)骨轉(zhuǎn)移的診斷。結(jié)論：肺癌患者應(yīng)常規(guī)行全身骨顯像，這對(duì)肺癌的分期、治療有著重要的臨床意義。［關(guān)鍵詞］肺癌；全身骨顯像；骨轉(zhuǎn)移［中圖分類號(hào)］R734.2［文獻(xiàn)標(biāo)識(shí)碼］B［文章編號(hào)］1673-7210(2011)11(c)-103-03ClinicalvalueofthewholebodyboneimagingindiagnosingbonemetastasisfromlungcancerJIALil,XIAZhengwu2,MAShixingl1.DepartmentofNuclearMedic
3、ine,YunnanProvincalCancerHospital,YunnanProvince,Kunming650118,China；2.DepartmentofLaboratory,KunmingGeneralHospitalofPLA,YurinanProvince,Kunming650032,China[Abstract]Objective：Toexploreclinicalvalueofthewholebodyboneimagingindiagnosingbonemetastasisfromlungcancer,inordertoguidestagingandtreatmentof
4、patientswithlungcancer.Methods：126patientswithpathologicaldiagnosisoflungcancerwereperformedwholebodyboneimaging,CTandALP,bloodcalciuminspection.Probabilityofbonemetastasisfromlungcancerofthedifferentpathologicaltypeanddifferentclinicalstagewerecounted.Thewholebodyboneimagingandclinicalfactorsofsusp
5、iciousbonemetastasis(includingbonepain,alkalinephosphatase,highcalciumlevels,arbitraryorafew)fordiagnosisaccuracyofbonemetastaseswerestatisticalcompared.Results：Theincidenceofbonemetastasisfromlungcancerwas27.8%,andthebonemetastasesoccurrenceprobabilityofperipherallungcancerwashigherthancentrallungc
6、ancer(P<0.01),bonemetastasesoccurrenceprobabilityoflungadenocarcinomawashigherthanlungsquamouscellcarcinoma(P<0.01),bonemetastasesoccurrenceprobabilityofperiodIII,IVpatientswasobviouslyhigherthanthatofperiodI,II(P<0.01).Thesensitivity(94.3%),specificdegrees(84.6%),accuracy(87?3%)ofthewholebodyboneim
7、agingdiagnosisofbonemetastasesfromlungcancerwerehigherthantheclinicalfactorsofsuspiciousbonemetastasisdiagnosisofbonemetastases?Conclusion：Wholebodyboneimagingshouldbearoutineexaminationinpatientswith
