^(99m)Tc-MDP全身骨扫描和血清CEA、NSE、CYFR21-1、CA125测定对小细胞肺癌骨转移的临床评价  

Clinical evaluation of ^(99m)Tc-MDP bone scintigraphy and serum CEA,NSE,CYFRA21-1 and CA125 in skeletal metastasis of the small cell lung cancer

作　　者：张炜[1] 郭万华 

机构地区：[1]东南大学医学院,江苏南京210009 [2]南京鼓楼医院核医学科,江苏南京210008

出　　处：《东南大学学报（医学版）》2015年第6期881-885,共5页Journal of Southeast University(Medical Science Edition)

基　　金：国家自然科学基金资助项目(81070684)

摘　　要：目的:分析^(99m)Tc-MDP全身骨扫描小细胞肺癌骨转移病灶分布特点及血清肿瘤标志物CEA、NSE、CYFRA21-1、CA125与小细胞肺癌骨转移发生的相关性。方法:回顾性分析56例经病理证实的小细胞肺癌患者^(99m)Tc-MDP全身骨扫描影像表现及血清肿瘤标志物水平,用ROC曲线及Spearman相关分析评价肿瘤标志物水平对肺癌骨转移发生及发展的诊断意义。结果:21例骨转移阳性病灶中胸部占46.60%,脊柱34.95%,骨盆9.71%,四肢5.83%,头颅2.91%。骨转移阳性组CEA、NSE质量浓度高于骨转移阴性组(均P<0.05),曲线下面积(AUC)分别为0.789、0.717,且CEA、NSE质量浓度与骨转移分级呈正相关(r值分别为0.540、0.417)。结论:小细胞肺癌以胸部及脊柱等中轴骨多发性骨转移为主,CEA、NSE血清水平随着骨转移病灶数的增加有显著上升趋势,对判定小细胞肺癌骨转移的发生及发展有一定的参考意义。Objective： To analyze the distribution characteristic of the skeletal metastasis lesion in ^99mTc-MDP bone scintigraphy and the correlation between serum tumor marker（ CEA,NSE,CYFRA21-1 and CA125） and skeletal metastasis in small cell lung cancer. Methods： 56 cases with small cell lung confirmed by pathology were examined with^99mTc-MDP bone scintigraphy. Serum concentration of CEA,NSE,CYFRA21-1 and CA125 were measured one week before whole-body bone scanning. ROC curve and spearman correlation analysis were used to evaluate the serum tumor markers in diagnose the development of the skeletal metastasis. Results： 21 imaging positive lesions were identified as the skeletal metastasis. The distribution of the skeletal metastasis lesions were：chest（ 46. 60%）,spine（ 34. 95%）,pelvis（ 9. 71%）,four limbs（ 5. 83%）,skull（ 2. 91%）. CEA,NSE levels in bone metastasis group were significant higher than those in the negative group（ P〈0. 05） and the area of ROC curve were 0. 789 and 0. 717 respectively（ P〈0. 05）. There was a correlation between concentration of CEA,NSE and classification of bone metastases. CEA and NSE level were the highest in the cases with wide spread bone metastasis. Conclusion： The bone metastasis lesions of small cell lung cancer are mostly seen in axial skeleton（ chest and spine）. The more number of bone metastasis lesions,the higher serum tumor markers level,the concentration of serum tumor markers for small cell lung cancer has certain reference significance to diagnose the occurrence and development of bone metastasis.

关 键 词：小细胞肺癌 全身骨扫描 骨转移 肿瘤标志物 

分 类 号：R730.4[医药卫生—肿瘤] R734.2[医药卫生—临床医学]