核素骨显像诊断老年性肺癌骨转移的临床价值

目的 评价核素骨显像在诊断老年性肺癌骨转移中的临床价值。方法 用ＳＰＥＣＴ核素全身骨显像探测及分析骨转移灶。结果 核素骨显像检出骨转移灶为１００．０％,明显高于Ｘ－ＣＴ（３０．０％）及Ｘ线平片（２５．０％）,且发现肺磷癌和肺腺癌发生骨转移率最高。结论 核素骨显像对老年性肺癌骨转移诊断有重要价值。     

糖尿病血清骨钙素水平与临床

本分析８３例糖尿病患骨钙素与碱性磷酸酶、钙、磷、雌二醇各参数的变应关系,结果显示：男性呈低ＢＧＰ,女性表现为你雌二醇与高ＢＧＰ,两组钙磷比例失调,提示糖尿病患骨吸收增强。     

糖尿病血清骨钙素水平与临床

本文分析83例糖尿病患者骨钙素与碱性磷酸酶、钙、磷、雌二醇各参数的变应关系,结果显示男性呈低BGP,女性表现为低雌二醇与高BGP,两组钙磷比例失调,提示糖尿病患者骨吸收增强.     

细胞因子与骨吸收及肺癌骨转移的相关性研究

为证实细胞因子与骨吸收及肺癌骨转移的相关性,得用新生鼠头骨建立体外骨吸收实验,验证白细胞介素－1（IL－1）、白细胞介素－6（IL－6）、肿瘤坏死因子（TNF）在体外对骨吸收的影响,并对部分肺癌骨转移阳性、阴性患者及正常人外周血核细胞培养上清（PBMCs)的骨吸收活笥（BRA）进行检测;同时测定了30例肺癌骨转移患者血清IL－1、IL－6、TNF水平,其中20例为多发骨转移（＞3处）。结果表明：①IL－1、IL－6、TNF均可促进体外骨吸收,IL－1作用最强;②肺癌骨转移患者PBMCs诱发的BRA明显增强,与对照组及正常人相比有显著差异;③肺癌多发骨转移患者血清IL－6水平明显高于对照组（P＜0.05）。上述结果验证了IL－1、IL－6、TNF的体外骨吸收活性,并提示细胞因子可能在肺癌骨转移产生骨破坏机制中占重要地位,而血清IL－6水平可以作为反映肺癌骨转移骨破坏程度的一个有意义的指标。     

肺癌患者骨显像97例分析

本文报告了９７例经痰癌细胞和／或病理学证实的肺癌患者骨显像的结果。对不同病理类型肺癌骨转移的特点和规律。骨转移区域分布以及肺癌患者发生骨痛情况进行了分析。结果表明：肺癌骨转移发生率为６６％，单发骨转移１８例，多发骨转移４６例，平均转移病灶数２．９，不同病理类型肺癌骨转移区域分别为胸部４９．４％，肖柱３８９％，肢体２５．７％，骨盆１７．５％，颅骨９．３％。     

肺癌骨转移发生及诊疗情况的临床研究

目的分析肺癌骨转移的发生及诊疗情况。方法分析2006年1月～2010年5月我科收治的99例肺癌骨转移患者的临床资料。结果肺癌骨转移的病理类型,腺癌37例（37.37%）,鳞癌28例（28.28%）,小细胞肺癌10例（10.10%）。最常见的转移部位是脊柱（32.34%）和肋骨（21.56%）、骨盆（19.16%）;骨转移主要临床症状疼痛68例;活动能力下降40例;病理性骨折、脊髓压迫等骨相关事件共87例次。通过综合治疗骨痛患者疼痛基本控制,75%的患者活动能力得到改善。结论肺癌中以腺癌发生骨转移居多,且多发骨转移多见,综合治疗可以控制症状。     

男性血清骨钙素水平与糖尿病性周围神经病变的相关性研究

目的探讨血清骨转换指标骨钙素水平对男性糖尿病性远端对称性多发性神经病变(DSPN)的影响。方法收集2020年1月至2021年11月复旦大学附属中山医院诊治的370例男性糖尿病患者的临床资料, 根据其血清骨钙素三分位水平将患者分为T1组(骨钙素<9.2 ng/mL, 123例)、T2组(骨钙素9.2～13 ng/mL, 122例)、T3组(骨钙素≥13 ng/mL, 125例), 比较3组间DSPN所占比例, 多元logistic回归计算不同组DSPN的发生风险。结果血清骨钙素T1、T2、T3组合并DSPN者分别为50例(40.7%)、29例(23.8%)、49例(39.2%), 骨钙素T2组DSPN合并率显著低于T1和T3组;在调整了年龄、糖尿病病程、HbA1C、糖尿病合并症、Ⅰ型胶原羧基端肽β交联肽(CTXβ)、血25-羟维生素D(25-OHD)、骨密度、治疗药物等多项混杂因素后, 相对于骨钙素T2组, T1、T3组DSPN风险分别增加133.9%(OR=2.339, 95%CI 1.097～4.988,P=0.028)和134.2%(OR=2.342, 95%CI 1.040...     

联合应用核素骨显像和CT诊断骨转移瘤

恶性肿瘤．特别是前列腺癌、肺癌、乳腺癌等常在疾病早期就有骨骼的转移。如能早期发现．对于治疗方案的选择和预后都有很大的帮助。核素骨显像(ECT)CT检查目前已经成为临床常用的肿瘤检查手段．二者相互比较和印证可以提高对骨转移瘤的诊断正确率。     

血清降钙素与肺癌骨转移的相关性

目的 探讨降钙素与肺癌发生骨转移的关系.方法 肺癌发生骨转移及未发生骨转移患者各20例,健康对照者20例.用化学发光法测定其血清降钙素浓度.随访0.5～1a.结果 有骨转移者的血清降钙素[(235.0±102.1)pg/ml]明显高于无骨转移者[(141.0±99.1)pg/ml]和健康对照者[(89.0±87.0)pg/ml],P<0.01.结论 血清降钙素可作为肺癌早期预测骨转移的指标,并有助于对肺癌骨转移患者进行随访和监测.血清降钙素低于正常值,发生骨转移的可能性相当低;高于正常值,则发生骨转移的可能性较大.     

血清NTx和BSP测定在非小细胞肺癌骨转移诊断中的价值

目的探讨骨唾液酸蛋白（BSP）和血清Ⅰ型胶原交联氨基末端肽（NTx）测定在非小细胞肺癌骨转移诊断中的临床意义。方法将67例肺癌患者初诊时分为骨转移组和无骨转移组,其中骨转移组32例,非骨转移组35例,并采用ELISA法对血清中NTx和BSP水平进行检测。初诊后12个月对肺癌患者骨转移情况采用影像学检查进行再次评估。结果与无骨转移组相比,骨转移组血清NTX和BSP含量显著升高（P〈0.01）。10例初诊为无骨转移者在随访过程中新发生骨转移癌。与无骨转移组相比,新发骨转移癌组和初诊骨转移组NTx和BSP含量均显著提高（P〈0.05）。结论血清NTx和BSP可用于非小细胞肺癌骨转移诊断,其含量的增高提示非小细胞肺癌患者可能发生了骨转移,从而有利于早期治疗。     

肺癌骨转移99mTc-MDP骨扫描最佳复查时间的研究

目的探讨肺癌患者骨扫描最佳复查时间。方法对2009年6月至2010年6月昆明医学院第三附属医院核医学科收治的127例原发性肺癌患者骨扫描结果(共346例次)进行回顾性分析,按照首次骨扫描结果分为正常组(61例)和异常组(66例),比较两组患者不同间隔时间的骨扫描变化情况。结果正常组在0~2个月、>2~4个月、>4~6个月、>6~12个月骨扫描变化率分别为1.61%(1/61)、3.3%(2/61)、13.1%(8/61)、27.9%(17/61);异常组在0~2个月、>2~4个月、>4~6个月、>6~12个月骨扫描变化率分别为4.5%(3/66)、25.8%(17/66)、39.4%(26/66)、42.4%(28/66);正常组骨扫描变化率0~2个月与>2~4个月变化率差异无统计学意义(P>0.05);与>4~6个月、>6~12个月变化率差异有统计学意义(P<0.05);异常组0~2个月骨扫描变化率与>2~4个月、>4~6个月、>6~12个月变化率差异有统计学意义(P<0.05)。结论临床应根据首次骨扫描的结果选择适当的复查时间,首次骨扫描正常者可以将复查时间定在6个月后;首次骨扫描异常者,应将复查时间定在2~4个月。     

唑来膦酸联合培美曲塞方案治疗非小细胞肺癌骨转移疗效研究

目的观察唑来膦酸联合培美曲塞治疗非小细胞肺癌（NSCLC）骨转移的疗效。方法 60例NSCLC骨转移患者,随机分为两组,分别为唑来膦酸组30例,对照组30例。唑来膦酸组接受唑来膦酸联合培美曲塞方案化疗,对照组为单纯培美曲塞方案化疗。结果两组肺部原发病灶有效率,唑来膦酸组有效率（CR＋PR）16.7%,疾病控制率（CR＋PR＋SD）60.0%;对照组有效率（CR＋PR）13.3%,疾病控制率（CR＋PR＋SD）53.3%。总体平均生存期7.5个月（2～17个月）,中位生存期唑来膦酸组7个月,对照组6个月。骨病灶控制唑来膦酸组的有效率（CR＋PR）40.0%,控制率（CR＋PR＋NC）83.3%,而对照组有效率13.3%,控制率36.7%。差异有显著性（P〈0.05）。骨转移疼痛缓解率唑来膦酸组79.2%,对照组45.8%。有显著性差异（P〈0.05）。结论唑来膦酸联合培美曲塞方案化疗对NSCLC骨转移不仅有较好的止痛作用,而且提高化疗疗效,是一种较佳的值得推广的临床选择方案。     

Predictors for survival in patients with bone metastasis of small cell lung cancer: A population-based study

The objective of the current study is to analyze the clinical and demographic characteristics of patients with bone metastasis of small cell lung cancer (SCLC) and explore their survival predictors.We retrospectively extracted patients with bone metastasis of SCLC from the Surveillance, Epidemiology, and End Results database. We applied Cox regression analyses to identify independent survival predictor of overall survival (OS) and cancer-specific survival (CSS). Only significant predictors from univariable analysis were included for multivariable Cox analysis. Kaplan–Meier method was used to evaluate survival differences between groups by the log–rank test.A total of 5120 patients with bone metastasis of SCLC were identified and included for survival analysis. The 1-year OS and CSS rates of bone metastasis of SCLC were 19.8% and 21.4%, respectively. On multivariable analysis, gender, age, radiotherapy, chemotherapy, liver metastasis, brain metastasis, insurance status, and marital status independently predicted OS and CSS. There was no significant difference of OS and CSS in terms of race and tumor size.Independent predictors of survival were identified among patients with bone metastasis of SCLC, which could be valuable to clinicians in treatment decision. Patients with bone metastasis of SCLC may benefit from radiotherapy and chemotherapy.     

肿瘤标志物对肺癌分期和骨转移诊断的价值

目的探讨肿瘤标志物癌胚抗原（CEA）、细胞角蛋白19的片段（CYFRA21—1）、神经稀醇酶（NSE）、糖类抗原（CA153）血清水平对肺癌分期及肺癌骨转移的辅助诊断价值。方法检测206例肺癌患者血清4种标志物水平,比较各期肺癌之间、骨转移组和无骨转移组之间的肿瘤标志物表达水平和阳性率的差异。结果骨转移组4项标志物水平均高于无骨转移组（P均〈0．05）;肺癌分期越晚,4项标志物阳性率越高;4项联检时灵敏度、准确率等均优于单项检查。结论肿瘤标志物水平的检测对肺癌骨转移的诊断、肺癌分期（特别是肺癌后期）诊断有辅助价值,联合检查优于单项检查：     

BRMS1在肺癌中的表达及其对肺癌细胞侵袭转移的影响

目的探讨乳腺癌转移抑制因子1(BRMS1)在肺癌中的表达及对肺癌细胞侵袭转移能力的影响。方法 Western blot及RT-PCR法检测肺癌及癌旁组织中BRMS1的表达,并将真核表达质粒p CMV-mycBRMS1及空白质粒转染到肺癌细胞A549。Transwell法检测细胞迁移和侵袭能力;Western blot检测核因子-κB(NF-κB)磷酸化水平及下游蛋白基质金属蛋白酶(MMP2),MMP9,骨桥蛋白(Osteopontin),E-钙粘蛋白(Ecadherin)的表达量。结果肺癌组织中BRMS1的蛋白及mRNA表达量都显著低于癌旁组织。与空白质粒组比较,真核表达质粒组中细胞迁移及侵袭能力降低,比值分别为[(0.98±0.10)及(0.17±0.03)],[(1.29±0.14)及(0.22±0.04)];NF-κB p65磷酸化水平降低,MMP2,MMP9,Osteopontin表达量下降,E-cadherin表达量上升(P0.01)。结论 BRMS1在肺癌组织中低表达,其过表达能显著抑制肺癌细胞A549侵袭转移,推测恢复肺癌组织BRMS1表达可能是转移性肺癌治疗方式之一。     

Clinicopathologic features of single bone metastasis in breast cancer

The most common site for metastasis in patients with breast cancer is the bone. In this case series, we investigated patients whose surgical and medical treatment for primary breast cancer was conducted at our center and first disease recurrence was limited to only 1 bone.We analyzed 910 breast cancer patients, 863 had no metastasis and 47 cases had a single bone metastasis ≥ 6 months after their first diagnosis. Demographic, epidemiological, histopathological and intrinsic tumor subtype differences between the non-metastatic group and the group with solitary bone metastases and their statistical significance were examined. Among established breast cancer risk factors, we studied twenty-nine variables.Three variables (Type of tumor surgery, TNM Stage III tumors and mixed type (invasive ductalcarsinoma + invasive lobular carcinoma) histology) were significant in multivariate logistic regression analysis. Accordingly, the risk of developing single bone metastasis was approximately 15 times higher in patients who underwent mastectomy and 4.8 and 2.8 times higher in those with TNM Stage III tumors and with mixed type (invasive ductal carcinoma + invasive lobular carcinoma) histology, respectively.In conclusion, the risk of developing single bone metastasis is likely in non-metastatic patients with Stage III tumors and possibly in mixed type tumors. Knowing this risk, especially in patients with mixed type tumors, may be instrumental in taking measures with different adjuvant therapies in future studies. Among these, treatment modalities such as prolonged hormone therapy and addition of bisphosphonates to the adjuvant treatments of stage III and mixed breast cancer patients may be considered.     

Bioinformatics analysis of breast cancer bone metastasis related gene-CXCR4

ObjectiveTo analyze breast cancer bone metastasis related gene-CXCR4.MethodsThis research screened breast cancer bone metastasis related genes by high-flux gene chip.ResultsIt was found that the expressions of 396 genes were different including 165 up-regulations and 231 down-regulations. The expression of chemokine receptor CXCR4 was obviously up-regulated in the tissue with breast cancer bone metastasis. Compared with the tissue without bone metastasis, there was significant difference, which indicated that CXCR4 played a vital role in breast cancer bone metastasis.ConclusionsThe bioinformatics analysis of CXCR4 can provide a certain basis for the occurrence and diagnosis of breast cancer bone metastasis, target gene therapy and evaluation of prognosis.