^(99)Tc^(m)-MDP全身骨显像在肺癌骨转移诊断中的价值研究  

Study on the value of ^(99)Tc^(m)-MDP whole-body bone imaging in the diagnosis of bone metastasis of lung cancer

作　　者：席泽 王健 陈萍 Xi Ze;Wang Jian;Chen Ping(Department of Nuclear Medicine,General Hospital of Huainan Oriental Hospital Group,Huainan 232001,China)

机构地区：[1]淮南东方医院集团总医院核医学科,淮南232001

出　　处：《国际放射医学核医学杂志》2024年第8期484-490,共7页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨^(99)Tc^(m)-亚甲基二膦酸盐(MDP)全身骨显像在肺癌骨转移诊断中的价值。方法回顾性分析2019年12月至2022年12月淮南东方医院集团总医院收治的118例肺癌患者的临床资料,其中男性62例、女性56例,年龄(69.5±7.6)岁,范围51~84岁。患者治疗前均行^(99)Tc^(m)-MDP全身骨显像,检查结束后对^(99)Tc^(m)-MDP全身骨显像结果、组织病理学检查结果和随访结果进行分析。通过Kappa检验分析^(99)Tc^(m)-MDP全身骨显像结果与组织病理学检查结果的一致性,评估^(99)Tc^(m)-MDP全身骨显像在肺癌骨转移诊断中的价值。采用χ2检验比较^(99)Tc^(m)-MDP全身骨显像对肺癌不同部位(胸部、中轴、盆腔和四肢)骨转移的诊断灵敏度、特异度、准确率、阳性预测值和阴性预测值。结果118例肺癌患者中,经组织病理学检查结果证实60例(50.85%)存在骨转移,其中颅骨转移2例(3.33%)、胸部骨转移10例(16.67%)、中轴骨转移29例(48.33%)、盆腔骨转移12例(20.00%)、四肢骨转移7例(11.67%);^(99)Tc^(m)-MDP全身骨显像结果显示57例(48.31%)为阳性,其中胸部骨转移10例(17.54%)、中轴骨转移27例(47.37%)、盆腔骨转移11例(19.30%)、四肢骨转移9例(15.79%)。Kappa检验分析结果显示,^(99)Tc^(m)-MDP全身骨显像与组织病理学检查对肺癌骨转移诊断结果的一致性强(Kappa值=0.839,P<0.001),对肺癌不同部位骨转移诊断结果的一致性均较强(Kappa值=0.648~0.732,均P<0.001)。^(99)Tc^(m)-MDP全身骨显像诊断肺癌骨转移的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为81.67%(49/60)、86.21%(50/58)、83.90%(99/118)、85.96%(49/57)、81.97%(50/61),^(99)Tc^(m)-MDP全身骨显像对肺癌胸部骨转移、中轴骨转移、盆腔骨转移和四肢骨转移的诊断灵敏度、特异度、准确率、阴性预测值的差异均无统计学意义(χ^(2)=1.790~9.136,均P>0.05);^(99)Tc^(m)-MDP全身骨显像对肺癌胸部骨转移和四肢骨转移的�ObjectiveTo explore the value of ^(99)Tc^(m)-methylene diphosphate(MDP)whole-body bone imaging in the diagnosis of bone metastasis of lung cancer.MethodsRetrospective analysis was conducted on the clinical data of 118 lung cancer patients admitted to General Hospital of Huainan Oriental Hospital Group from December 2019 to December 2022,including 62 males and 56 females,aged(69.5±7.6)years,with a range of 51–84 years old.Before treatment,all patients underwent ^(99)Tc^(m)-MDP whole-body bone imaging.After the examination,the results of ^(99)Tc^(m)-MDP whole-body bone imaging,histopathological examination,and follow-up were subjected to analysis.Kappa analysis was used to analyze the consistency between the results of ^(99)Tc^(m)-MDP whole-body bone imaging and histopathological examination and evaluate the importance of ^(99)Tc^(m)-MDP whole-body bone imaging in the diagnosis of lung cancer bone metastasis.Chi square test was used to compare the sensitivity,specificity,accuracy,and positive and negative predictive values of bone metastasis in different parts of lung cancer(chest bone,axial bone,pelvic bone,and limb bone).ResultsAmong 118 lung cancer patients,60 cases(50.85%)were confirmed to have bone metastases through histopathological examination.These confirmed cases included 2 cases of skull metastases(3.33%),10 cases of chest bone metastases(16.67%),29 cases of axial bone metastases(48.33%),12 cases of pelvic bone metastases(20.00%),and 7 cases of limb bone metastases(11.67%).The ^(99)Tc^(m)-MDP whole-body bone imaging results reveal that 57 cases(48.31%)were positive for bone metastases,including 10 cases of chest bone metastases(17.54%),27 cases of axial bone metastases(47.37%),11 cases of pelvic bone metastases(19.30%),and 9 cases of limb bone metastases(15.79%).Kappa analysis results indicate a strong consistency between ^(99)Tc^(m)-MDP whole-body bone imaging and histopathological examination in the diagnosis of lung cancer bone metastasis(Kappa value=0.839,P<0.001)and in the diagnosis of bone metas

关 键 词：肺肿瘤 肿瘤转移 骨骼 放射性核素显像 99M锝美罗酸盐 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]