When Should ⁹⁹mTc Bone Scintigraphy Be Performed in cT1N0 Non-Small Cell Lung Cancer Patients?
When Should ⁹⁹mTc Bone Scintigraphy Be Performed in cT1N0 Non-Small Cell Lung Cancer Patients?
复制标题
cT1N0 非小细胞肺癌患者何时应进行 Tc-99m 骨闪烁扫描？
DOI：
10.1097/md.0000000000002309
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发表时间：
2015-12
期刊：
影响因子：
1.6
通讯作者：
Chen H
中科院分区：
文献类型：
--
作者：
Li H;Hu H;Wang R;Zhang Y;Xiang J;Liu Q;Shi W;Sun Y;Chen H
本回顾性研究的目的是调查临床T1 N 0非小细胞肺癌（NSCLC）患者骨转移（BM）的危险因素。从2010年1月至2012年6月，739例初次诊断为cT 1 N 0 NSCLC的患者有资格参加本研究。收集临床变量，包括性别、吸烟史、诊断年龄、肿瘤大小、病理亚型、术前血清癌胚抗原（CEA）水平、病变成像表现和骨骼系统症状。7例（0.95%）有骨髓转移，6例有骨骼系统症状，1例无转移。BM的发生率在年轻患者中显著较高（P = 0.007），在术前血清CEA水平较高的患者中显著较高（P = 0.05）。 多因素分析显示，年龄<50岁（OR = 2.23，95%CI：1.56-4.21，P = 0.02）、有临床症状（OR = 3.15，95%CI：1.98-6.42，P = 0.008）、CEA水平> 5 μg/mL（OR = 2.14，95%CI：1.37-3.53，P = 0.03）是cT 1 N 0 NSCLC患者BM的独立相关因素。 存在骨骼系统症状不是进行BS的唯一标准。诊断时年龄较小和术前血清CEA水平较高也是cT 1 N 0 NSCLC患者BM的危险因素。因此，在选择早期非小细胞肺癌患者进行BS应在未来更精确。
The aim of this retrospective study was to investigate the risk factors for bone metastases (BM) in clinical T1N0 non-small cell lung cancer (NSCLC) patients. From January 2010 to June 2012, 739 patients with primary diagnosed cT1N0 NSCLC were eligible for this study. Clinical variables, including sex, smoking history, age at diagnosis, tumor size, pathologic subtype, preoperative serum Carcino embryonie antigen (CEA) level, lesion imaging performance, and skeletal system symptom, were collected. BM were found in 7 patients (0.95%), in whom 6 patients had skeletal system symptom and 1 had silent metastasis. The frequency of BM was significantly high in younger patients (P = 0.007) and in patients with higher preoperative serum CEA level (P = 0.05). In multivariate analysis, age less than 50 years old (OR = 2.23, 95% CI: 1.56–4.21, P = 0.02), presence of clinical symptom (OR = 3.15, 95% CI: 1.98–6.42, P = 0.008), and CEA level over 5 μg/mL (OR = 2.14, 95% CI: 1.37–3.53, P = 0.03) were independently associated with BM in cT1N0 NSCLC patients. Presence of skeletal system symptom is not the unique criteria for performing BS. Younger age at diagnosis and higher preoperative serum CEA level are also risk factors for BM in cT1N0 NSCLC patients. Therefore, the selection of early-stage NSCLC patients being performed BS should be more precise in the future.