老年肺癌患者^(99m)Tc-亚甲基二磷酸盐全身骨扫描的临床应用  

Clinical application of ^(99m)Tc,methylene diphosphonate bone scanning in senile lung cancer patients

作　　者：杨忠毅[1] 管樑[1] 田伟家[1] 朱承谟[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院核医学科,上海200025

出　　处：《内科理论与实践》2007年第3期175-178,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:探讨99mTc-亚甲基二磷酸盐(MDP)全身骨扫描在老年肺癌患者中的临床应用。方法:回顾性分析90例75岁以上老年肺癌患者99mTc-MDP全身骨扫描的资料。结果:99mTc-MDP全身骨扫描提示肿瘤骨转移44例(48.89%),阴性结果28例(31.11%),退行性变18例(20.00%);肿瘤转移、阴性结果与退行性变3组患者之间的年龄差异有统计学意义(P<0.05),以退行性变患者的年龄最大,肿瘤转移患者次之,阴性结果患者年龄最小;肿瘤骨转移中以多发转移为主,占59.09%(26/44),其次为单发转移,占29.55%(13/44);2个部位的转移占11.36%(5/44);肿瘤转移部位依次多见于脊柱(75.00%,33/44)、胸部(61.36%,27/44)、骨盆(29.55%,13/44)、颅骨(9.09%,4/44)和肢体(6.82%,3/44)。结论:99mTc-MDP全身骨扫描在75岁以上老年肺癌患者中有一定的应用价值。对于75岁以上的老年肺癌患者,在骨扫描图像上若出现放射性浓聚,尚需排除退行性变的可能性,且年龄越大,其退行性变的可能性也相应增高。Objective To evaluate the role of ^99mTc-methylene diphosphonate （MDP） bone scanning in determining bone metastasis in the senile lung cancer patients. Methods Ninety patients over 75-years-old with lung cancer was enrolled in this retrospective study. Results Bone metastases were detected in 44 patients （48.89%）, negative results were found in 28 patients （31.11%）, and degenerations were detected in the other 18 patients （20.00%）. The age distribution was significantly different among these three groups（P〈0.05 ）. The patients with degeneration lesions were the oldest, while those with negative results were the youngest. The percentages of multiple and isolated bone metastasis were 59.09% and 29.55%. The most common sites of bone metastases were the vertebral column （75.00%）, the chest （61.36%）, the pelvis （29.55%）, the cranial bone（9.09%）, and the extremities （6.82%）. Conclusions ^99mTc-MDP bone scanning is a valuable technique in detecting bone metastasis in the senile lung cancer patients. Degeneration lesions should be excluded while abnormal findings demonstrated.

关 键 词：肺癌 骨转移 骨扫描 老年人 

分 类 号：R734.2[医药卫生—肿瘤] R816.8[医药卫生—临床医学]