单光子发射计算机断层扫描仪核素骨显像联合血清Ⅰ型胶原羧基端肽、抗酒石酸酸性磷酸酶5b诊断乳腺癌骨转移194例分析  

Analysis of 194 cases of breast cancer bone metastasis by SPECT radionuclide bone imaging combined with serum I-CTP and TRACP5b

作　　者：王洪伟 张建伟 吴云飞 WANG Hongwei;ZHANG Jianwei;WU Yunfei(Department of Nuclear Medicine,Zhumadian Central Hospital,Zhumadian,Henan 463000,China)

机构地区：[1]驻马店市中心医院核医学科,河南驻马店463000

出　　处：《安徽医药》2022年第3期578-581,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析单光子发射计算机断层扫描仪(SPECT)核素骨显像联合血清Ⅰ型胶原羧基端肽(ⅠCTP)、抗酒石酸酸性磷酸酶5b(TRACP5b)诊断乳腺癌骨转移的临床价值。方法选取2016年1月至2019年1月驻马店市中心医院确诊的乳腺癌病人194例,采用SPECT对入组病人进行全身显像检查,按Soloway骨显像分级标准分为S0组(n=51)、S1组(n=56)、S2组(n=63)和S3组(n=24),同时采用酶联免疫吸附测定(ELISA)检测血清ⅠCTP、TRACP5b水平,分析SPECT核素骨显像检测、血清ⅠCTP、TRACP5b检测以及SPECT核素骨显像联合血清ⅠCTP、TRACP5b检测在乳腺癌骨转移诊断中的曲线下面积(AUC)、灵敏度和特异度。结果SPECT核素骨显像检查显示194例乳腺癌术后病人中有143例发生骨转移,转移率为73.71%,共发现骨转移病灶1217个;S0组、S1组、S2组和S3组四组病人血清ⅠCTP[(4.78±3.61)μg/L,(9.86±3.15)μg/L,(17.02±6.35)μg/L,(21.67±7.25)μg/L]、TRACP5b[(3.59±4.11)U/L,(7.42±2.89)U/L,(10.23±4.68)U/L,(17.81±7.20)U/L]水平比较结果显示,S0组<S1组<S2组<S3组,组间对比差异有统计学意义(P<0.05);Spearman相关性分析结果显示,SPECT核素骨显像Soloway分级与血清ⅠCTP、TRACP5b水平存在明显正相关性(P<0.05);ROC曲线诊断结果显示,SPECT核素骨显像联合血清ⅠCTP、TRACP5b检测对乳腺癌骨转移诊断的AUC为0.954,灵敏度为98.60%,特异度为86.30%,均高于SPECT核素骨显像单独检测和血清ⅠCTP、TRACP5b单独检测以及ⅠCTP+TRACP5b检测。结论SPECT核素骨显像联合血清ⅠCTP、TRACP5b检测在乳腺癌骨转移诊断中的灵敏度和特异度均较高,是一种理想的乳腺癌骨转移诊断方式。Objective To analyze the clinical value of single photon emission computed tomography(SPECT)radionuclide bone im⁃aging combined with serum type I collagen carboxyterminal telopeptide(I-CTP)and blood tartrate-resistant acid phosphatase 5b(TRACP5b)in the diagnosis of breast cancer bone metastasis.Methods A total of 194 breast cancer patients diagnosed in Zhumadian Central Hospital from January 2016 to January 2019 were selected.SPECT was used to perform whole body imaging examination on the enrolled patients,and they were divided into the S0 group(n=51),S1 group(n=56),S2 group(n=63)and S3 group(n=24)according to the Soloway bone imaging grading standard.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum I-CTP and TRACP5b.To analyze the area under the curve(AUC),sensitivity and specificity of SPECT radionuclide bone imaging detection,serum I-CTP,TRACP5b detection and SPECT radionuclide bone imaging combined with serum I-CTP and TRACP5b in the diagnosis of breast cancer bone metastasis.Results SPECT radionuclide bone imaging showed that 143 of 194 breast cancer patients had bone metastases,the metastasis rate was 73.71%,and there were 1,217 bone metastases.Comparison of serum I-CTP[(4.78±3.61)μg/L,(9.86±3.15)μg/L,(17.02±6.35)μg/L,(21.67±7.25)μg/L]and TRACP5b[(3.59±4.11)U/L,(7.42±2.89)U/L,(10.23±4.68)U/L,(17.81±7.20)U/L]levels in the S_(0) group,S_(1) group,S_(2) group and S_(3) group showed that the S_(0) group<S_(1) group<S_(2) group<S_(3) group(P<0.05).Spearman correlation analysis showed that the Soloway grading of SPECT radionuclide bone imaging was significantly positively corre⁃lated with levels of serum I-CTP and TRACP5b(P<0.05).ROC curve diagnosis results showed that the AUC,sensitivity and specifici⁃ty of SPECT radionuclide bone imaging combined with serum I-CTP and TRACP5b detection in the diagnosis of breast cancer bone me⁃tastasis were 0.954,98.60%and 86.30%respectively,which were higher than those of SPECT radionuclide bone imaging detection alone or serum

关 键 词：乳腺肿瘤 骨转移 单光子发射计算机断层扫描仪核素骨显像 Ⅰ型胶原羧基端肽 抗酒石酸酸性磷酸酶5B 

分 类 号：R737.9[医药卫生—肿瘤]