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目的 对原发性肺癌进行全身骨显象 ,结合病理诊断进行临床分析。方法 3 10例原发性肺癌均经病理确诊 ,男女之比为 3 5∶1,平均年龄为 5 1 5岁。静脉注射 99mTc -MDP( 2 0～ 3 0 )× 3 7MBq ,3小时后作全身骨显象。组间差异显著性用t及 χ2 检验。结果 原发性肺癌骨显象阳性率为 81 3 % ( 2 5 2 /3 10 )。按不同病理类型及细胞的分化程度 ,肺癌骨转移的频度依次为腺癌、鳞癌、混合型癌及小细胞癌 ,按电镜分型混合型居肺癌骨转移的首位 ,骨转移部位顺序依次为胸骨、脊椎、骨盆、四肢及颅骨。多发性转移 90 1%( 2 2 7/2 5 2 ) ,平均每例为 6 1个转移灶。结论 肺癌骨显象对临床TNM分期、治疗方案制订及预后判断至关重要 ,结合病理类型 ,特别是癌细胞分化程度及电镜分型更符合临床实际 ,可以解释肺癌的异常生物行为。
Objective To perform whole-body bone imaging on primary lung cancer and combine pathological diagnosis with clinical analysis. Methods 3 10 cases of primary lung cancer were diagnosed by pathology. The ratio of male to female was 35:1 and the average age was 515 years old. Intravenous injection of 99mTc-MDP (20- 30) 3 7 MBq was performed and whole body bone imaging was performed 3 hours later. The significance of differences between groups was tested using t and χ2. Results The positive rate of bone imaging in primary lung cancer was 81 3% (2 5 2 /3 10 ). According to different pathological types and cell differentiation, the frequency of bone metastases in lung cancer was adenocarcinoma, squamous cell carcinoma, mixed carcinoma, and small cell carcinoma in turn. The first place of bone metastases was lung cancer by electron microscopy type. The order of bone metastases was in turn For the sternum, spine, pelvis, limbs and skull. Multiple metastases were 90 1% (2 2 7/2 5 2 ), with an average of 61 metastases per patient. Conclusion Bone scan in lung cancer is very important for clinical TNM staging, treatment plan formulation and prognosis. Combining with pathological types, especially cancer cell differentiation and electron microscopy, it is more in line with clinical practice and can explain the abnormal biological behavior of lung cancer.