肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2011年
5期
318-320
,共3页
伍建蓉%郑玲%杨红%白娟
伍建蓉%鄭玲%楊紅%白娟
오건용%정령%양홍%백연
肺肿瘤%肿瘤转移%放射性核素显像%碱性磷酸酶
肺腫瘤%腫瘤轉移%放射性覈素顯像%堿性燐痠酶
폐종류%종류전이%방사성핵소현상%감성린산매
Lung neoplasms%Neoplasm metastasis%Radionuclide imaging%Alkaline phosphatase
目的 探讨全身骨显像和血清骨型碱性磷酸酶(B-ALP)对肺癌骨转移的诊断价值.方法 对58例肺癌患者进行全身骨显像,同时测定血清碱性磷酸酶(ALP)、B-ALP水平,对其结果进行比较分析.结果 58例患者中,骨转移33例,转移率56.90%.其中肺腺癌的骨转移率为70.97%(22/33),肺鳞状细胞癌为42.86%(9/21),差异有统计学意义(x2=4.109,P=0.0427).血清B-ALP水平≥150U/L 者骨转移发生率为95.46%(21/22),血清B-ALP水平<150 U/L者骨转移发生率为33.33%(12/36),差异有统计学意义(x2=21.487,P=0.0000).骨转移灶≤3处组与>3处组B-ALP分别为(125.00±25.00)U/L和(176.14±49.09)U/L,两组间B-ALP水平差异有统计学意义(精确概率法,P=0.0013).在诊断敏感性和特异性的比较中,骨显像诊断的敏感度最高,达到93.94%,但其特异度最低,为92.00%;而骨显像+B-ALP敏感度降低至57.58%,但特异度可达到100.00%.结论 诊断肺癌骨转移应首选骨显像.同时检测血清B-ALP有助于明确肺癌患者核素骨显像异常表现的病变性质,联合检测B-ALP+骨显像可以提高诊断特异度.血清B-ALP对肺癌骨转移诊断及病情判断有一定临床应用价值.
目的 探討全身骨顯像和血清骨型堿性燐痠酶(B-ALP)對肺癌骨轉移的診斷價值.方法 對58例肺癌患者進行全身骨顯像,同時測定血清堿性燐痠酶(ALP)、B-ALP水平,對其結果進行比較分析.結果 58例患者中,骨轉移33例,轉移率56.90%.其中肺腺癌的骨轉移率為70.97%(22/33),肺鱗狀細胞癌為42.86%(9/21),差異有統計學意義(x2=4.109,P=0.0427).血清B-ALP水平≥150U/L 者骨轉移髮生率為95.46%(21/22),血清B-ALP水平<150 U/L者骨轉移髮生率為33.33%(12/36),差異有統計學意義(x2=21.487,P=0.0000).骨轉移竈≤3處組與>3處組B-ALP分彆為(125.00±25.00)U/L和(176.14±49.09)U/L,兩組間B-ALP水平差異有統計學意義(精確概率法,P=0.0013).在診斷敏感性和特異性的比較中,骨顯像診斷的敏感度最高,達到93.94%,但其特異度最低,為92.00%;而骨顯像+B-ALP敏感度降低至57.58%,但特異度可達到100.00%.結論 診斷肺癌骨轉移應首選骨顯像.同時檢測血清B-ALP有助于明確肺癌患者覈素骨顯像異常錶現的病變性質,聯閤檢測B-ALP+骨顯像可以提高診斷特異度.血清B-ALP對肺癌骨轉移診斷及病情判斷有一定臨床應用價值.
목적 탐토전신골현상화혈청골형감성린산매(B-ALP)대폐암골전이적진단개치.방법 대58례폐암환자진행전신골현상,동시측정혈청감성린산매(ALP)、B-ALP수평,대기결과진행비교분석.결과 58례환자중,골전이33례,전이솔56.90%.기중폐선암적골전이솔위70.97%(22/33),폐린상세포암위42.86%(9/21),차이유통계학의의(x2=4.109,P=0.0427).혈청B-ALP수평≥150U/L 자골전이발생솔위95.46%(21/22),혈청B-ALP수평<150 U/L자골전이발생솔위33.33%(12/36),차이유통계학의의(x2=21.487,P=0.0000).골전이조≤3처조여>3처조B-ALP분별위(125.00±25.00)U/L화(176.14±49.09)U/L,량조간B-ALP수평차이유통계학의의(정학개솔법,P=0.0013).재진단민감성화특이성적비교중,골현상진단적민감도최고,체도93.94%,단기특이도최저,위92.00%;이골현상+B-ALP민감도강저지57.58%,단특이도가체도100.00%.결론 진단폐암골전이응수선골현상.동시검측혈청B-ALP유조우명학폐암환자핵소골현상이상표현적병변성질,연합검측B-ALP+골현상가이제고진단특이도.혈청B-ALP대폐암골전이진단급병정판단유일정림상응용개치.
Objective To assess the diagnostic value of bone scanning and bone alkaline phosphatase (B-ALP) detection in diagnosis of osseous metastases in lung cancer. Methods 58 patients with lung cancer were examined by bone scanning and serum alkaline phosphates(ALP) and B-ALP detection. The results were analyzed. Results Among the 58 patients, bone scanning found osseous metastases in 33 patients, the incidence was 56.90 %. Among the 58 patients, the incidence of bone metastasis of adenocarcinoma was 70.97 % (22/33) and squamous carcinoma was 42.86 % (9/21) (x2 =4.109, P =0.0427). The incidence of bone metastases increased in B-ALP ≥150 U/L. B-ALP was significantly correlated with the number of metastatic loci in bone. The sensitivity of bone scanning is the highest (93.94 %), but specificity the lowest (92.00 %).The sensitivity combining bone scanning and B-ALP is the lowest (57.58 %), but the specificity the highest (100.00 %). Conclusion Whole-body bone scanning has high sensitivity in early detection of bone metastases. For diagnosis of osseous metastases in patients with lung cancer, bone scanning is the primary choice. Combining the bone scanning with B-ALP can increase specificity. B-ALP has certain using value to confirm bone metastasis and decide the disease extent.
