- 期刊
同位素骨骼掃描對惡性腫瘤骨轉移的診斷
Bone Metastases of Malignancies a Radionuclide Study
摘要
同位素骨骼掃描的臨床應用範圍很廣，其中最主要的目的之一，即在于決定惡性腫瘤是否合併有骨骼轉移，以做為腫瘤的分期及追蹤治療的根據。從1985年1月至9月間，在本科接受全身骨骼掃描的惡性腫瘤病人共有341例，其中男性199例、女性142例，年齡平均為52.4±13.4歲。所有的病人在接受15~20mCi的Tc-99m-methylene diphosphonate靜脈注射3~4小時後，以附有平行孔低能階準直儀之伽瑪閃爍機掃描全身骨骼。結果依病例多寡的前10種惡性腫瘤，按其骨骼轉移的陽性率之順序，分別為j鼻咽癌69%(50／72)，k肺癌61%(22／36)，l子宮頸癌55%(11／20)，m乳癌45%(17／38)，n喉癌44%(4／9)，o大腸癌33%(6／18)，p膀胱癌33%(4／12)，q胃癌20%(2／10)，r肝癌15%(6／39)，s惡性淋巴瘤8%(1／12)。單發性骨骼轉移和多發性轉移之比為1：3。而所有骨骼轉移以脊椎為最多佔34%(79／231)，其次為肋骨及頭骨分別為18%(42／231) 和17%(40／231)而以胸骨為最少，只佔1%(2／231)。 本文惡性腫瘤病例的骨骼轉移，顯然比文獻報告的為高，這或許和我們的病例較多屬于嚴重的末期有關；且可推論臨床諸科醫師較少將早期癌的病例送來做骨骼掃描。
關鍵字
無資料並列摘要
Radionuclide (RN) bone scan is very valuable in follow-up studies of a variety of clinical conditions. One of the most important indication of bone scan is to determine the occult bone metastases for accurate staging and treatment planning of malignant diseases. In this report, we intended to re-emphasize the importance of RN bone scan as an accurate diagnostic tool and to review current literature. From Jan. 1985 to Sep. 1985, 341 cases with known malignant diseases received RN bone scan examination; 199 of them were male, and 142 were female. Patients were between 4 and 88 years of age, with a mean age of 52.4 ±1.34 years old (mean ± SD). The 10 most common malignancies among them were (1) naso-pharyngeal carcinoma (NPC): 72; (2) hepatocellular carcinoma: 39; (3) breast cancer: 38 (4) bronchogenic carcinoma: 36; (5) urinary bladder cancer: 12; (8) malignant lymphoma: 12 (9) gastric cancer: 10; and (10) laryngeal cancer: 9. The rate of occurrence of bone metastases of these neoplasmas were (1) NPC: 69%; (2) bronchogenic cancer: 64%; (3) uterine cervix cancer: 55%; (4) breast cancer: 45% (5) laryngeal cancer: 44%; (6) colo-rectal cancer: 33%; (7) urinary bladder cancer: 33%; (8) gastric cancer: 20%; (9) hepatocellular carcinoma: 15%; and (10) malignant lymphoma: 8%. Sites of bone metastases were as follows (1) vertebrae: 34%(79/231); (4) pelvis: 15%(35/231); (5) long bones: 9%(21/231); (6) scapula: 3%(8/231); (7) clavicle: 2%(4/231); (8) sternum: 1%(2/231). Soliary bone metastasis occurred in 24.8%(37/149) of those with bone metastases. The rate that bone metastases occurred in our cases was higher than those which previously been reported. The reason may be that most cases of malignancy referred to us were in more advanced in stages than were those in previous studies.