醫學新知
  鏡湖醫學
  2017年11月份醫學常識講座
  2017年10月份醫學常識講座
  2017年9月份醫學常識講座
  2017年7至12月孕期講座座
  首頁 > 醫學新知 > 鏡湖醫學 > 第23期內容
 
  標題:澳門惡性腫瘤患者行99mTc-MDP骨掃描的臨床價值
    

澳門惡性腫瘤患者行99mTc-MDP骨掃描的臨床價值
余國威  馬林峰  郭詠楠  李志榮  周家豪  唐權  鄭瑾璇  謝學斌


【摘要】 

目的   探討澳門人群惡性腫瘤患者行99mTc-MDP骨掃描的臨床價值。
方法   回顧性分析澳門地區2005年至2010年期間行骨掃描的389例惡性腫瘤患者,取本組發病率前5位的惡性腫瘤病種進行資料分析,由兼具放射學及核醫學臨床背景的醫師閱讀每例SPECT(SPECT/CT)圖像,然後挑選出骨掃描有陽性發現的病例進行追蹤隨訪,結合病理、影像學或臨床隨訪來驗證診斷結果,得出骨掃描對不同病種骨轉移檢出的準確率以及其解剖學分佈特點,從而分析99mTc-MDP骨掃描臨床價值。
結果   389例行骨掃描惡性腫瘤病例中數量居前5位分別為乳腺癌160例、鼻咽癌56例、前列腺癌52例、肺癌36例、大腸癌15例。骨掃描有骨轉移和有隨訪結果的分別為乳腺癌23例、鼻咽癌22例、前列腺癌24例、肺癌22例、大腸癌9例。骨掃描發現骨轉移的準確性為乳腺癌91.3%、鼻咽癌61.5%、前列腺癌66.7%、肺癌90.9%、大腸癌88.9%。各病種骨轉移灶數目常見部位:前列腺癌、肺癌、大腸癌為脊椎>骨盆>肋骨>四肢骨及顱骨,乳腺癌、鼻咽癌為脊椎>肋骨>骨盆>四肢骨,然而鼻咽癌局部顱骨侵犯最常見。
結論   澳門地區惡性腫瘤患者行骨掃描以乳腺癌、鼻咽癌、前列腺癌、肺癌及大腸癌多見。骨掃描對發現乳腺癌、肺癌及大腸癌骨轉移準確性最高,並以脊柱轉移最多見,而乳腺癌由於解剖關係發生肋骨轉移是第二好發部位。骨掃描對於乳腺癌、肺癌、大腸癌等惡性腫瘤臨床M分期有著重要的價值。

 

【關鍵詞】 惡性腫瘤;骨掃描;99mTc -亞甲基二磷酸鹽;澳門


Clinical value of 99mTc-MDP bone scan for malignant tumor patients in Macau
IU Kuok-wai, MA Lin-feng, KUOK Weng-nam, LEI Chi-weng, CHAO Kahou, TANG Quan, CHEANG Kan-sun, XIE Xue-bin
Imaging diagnostic center, Kiang Wu hospital, Macau

 

[Abstract] 

Objective   In view of Macau’s population composition is different from other regions, and so far there is no related literature of 99mTc-MDP bone scan for malignant tumor patients in Macau are reported. The purpose of this study was to investigate clinical value of 99mTc-MDP bone scan for malignant tumor patients among Macau’s population.
Methods     Retrospectively analyze 389 patients with malignant tumors having bone scan during the period from 2005 to 2010 in Macau. The data, which was the top five of incidence rate in this group, was analyzed. The SPECT(SPECT/CT) images of each case were read by the physicians who had the clinical experience with both radiology and nuclear medicine, and then picked out the positive cases to follow up. The diagnosis was verified by the combination of pathology, imaging or clinical follow-ups. We got the bone metastases detection accuracy of different malignances by bone scan as well as its anatomical distribution. Therefore, the clinical value of 99mTc-MDP bone scan was obtained.
Results    The top five numbers of tumors among 389 cases of bone scan were 160 cases of breast cancer, nasopharyngeal carcinoma in 56 cases, 52 cases of prostate cancer, lung cancer in 36 cases, 15 cases of colorectal cancer. The cases of bone scan showed bone metastases and have follow-up results were 23 cases of breast cancer, nasopharyngeal carcinoma in 22 cases, 24 cases of prostate cancer, lung cancer in 22 cases, 9 cases of colorectal cancer, respectively. The accuracy of bone scan in revealing bone metastases in breast cancer was 91.3%, NPC 61.5%, 66.7% of prostate cancer, lung cancer 90.9%, 88.9% of colorectal cancer. The common sites of bone metastases were: spine> pelvis> ribs> limbs and skull in the prostate cancer, lung cancer and colorectal cancer, spine> ribs> pelvis> limbs in the breast cancer and nasopharyngeal cancer, but the skull is the most common site of local invasion in nasopharyngeal carcinoma.
Conclusion The common tumor patients undergone bone scans are breast cancer, nasopharyngeal cancer, prostate cancer, lung cancer and colorectal cancer. The higher accuracy of bone metastases detection by bone scan is breast cancer, lung cancer and colorectal cancer, and the most common metastasis site is spine. The second metastasis predilection site of breast cancer is rib. Bone scan has important clinical value of M staging for breast cancer, lung cancer, colorectal cancer and other malignant tumors.

 

[Key Words]  Malignant tumor; Skeletal scintigraphy; 99mTc-MDP; Macau

 

 
   

Copyright (c) 2008 Kiang Wu Hospital. All rights reserved.
最佳瀏覽效果:IE 6.0 1024 x 768  電話:00853-28371333  地址:鏡湖醫院位於澳門連勝街
傳真:00853-28347752   電郵: prd@kwh.org.mo