肾癌患者核素骨显像必要性分析

目的 探讨肾癌患者核素骨显像检查的必要性.方法 行核素骨显像的肾癌患者152例.男106例,女46例.年龄11～86岁,平均56岁.肿瘤直径1.5～20.0 cm,平均6 cm.TNM和AJCC分期:I期88例,其中T1a47例、T1b41例;Ⅱ期38例;Ⅲ期16例,其中T3a10例、T3b6例;Ⅳ期10例.组织学分级高分化90例,中分化43例,低分化19例.应用Logistic回归对10项可能影响肾癌骨转移的临床病理学因素进行分析.结果 152例患者中核素骨显像异常33例,其中骨转移22例(14.5%).126例局限性肾癌中发生骨转移11例(8.7%);16例局部进展性肾癌中发生骨转移5例(31.2%);10例转移性肾癌中发生骨转移6例(60%).Logistic回归分析结果表明肾癌骨转移与临床分期相关,肾癌中有骨痛症状者骨转移率为40.9%(9/22).结论局限性肾癌(Ⅰ、Ⅱ期)患者不必常规行骨显像检查,有骨痛症状情况下可考虑使用;临床分期≥Ⅲ期者,不管有无骨痛症状均应考虑核素骨显像检查. 能影响肾癌骨转移的临床病理学因素进行分析.结果 152例患者中核素骨显像异常33例,其中骨转移22例(14.5%).126 局限性肾癌中发生骨转移11例(8.7%);16例局部进展性肾癌中发生骨转移5例(31.2%);10例转移性肾癌中发生骨转移6例(60%).Logistic回归分析结果表明肾癌骨转移与临床分期相关,肾癌中有骨痛症状者骨转移率为40.9%(9/22).结论局限性肾癌(Ⅰ、Ⅱ期)患者不必常规行骨显像检查,有骨痛症状情况下可考虑使用;临床分期≥Ⅲ期者,不管有无骨痛症状均应考虑核素骨显像检查. 能影响肾癌骨转移的临床病理学因素进行

Bone scintigraphy in patients with renal cell carcinoma

Objective To investigate essentiality of bone scintigraphy in patients with renal cellcarcinoma.Methods The clinical data of 152 patients with confirmed renal cell carcinoma from Jan uary 1999 to June 2007 were retrospectively analyzed.There were 106 men and 46 women with a meanage of 56 years (range 11-86 years).The tumor size was 1.5-20.0 cm (mean 6.0 cm).Accordingto the TNM and AJCC staging classification,88 patients had stage I,included of T1a in 47 cases,T1bin 41; 38 had stage Ⅱ; 16 had stage Ⅲ,included of T3a,in 10 cases,T3b in 6; and 10 had stage Ⅳ.Histological grade was well differentiated in 90 cases,moderately in 43,poor in 19.Ten clinical pa thology factors were evaluated by Logistic analysis to present the significant factors related to osseousmetastatic lesions.Results Overall osseous metastatic lesions were present in 22 of the 152 patients(14.5%).Of the 126 patients with clinically localized,11 cases (8.7%) had osseous metastatic le sions.Of the 16 patients with clinically advanced,5 eases (31.2%) had osseous metastatic lesions.Ofthe 10 patients with metastasis,6 cases(60%) had osseous metastatic lesions.Clinical stage was re lated to osseous metastatic lesions by Logistic analysis.The incidence of osseous metastatic lesionswas 40.9% in localized renal cell carcinoma patients with bone pain.Conclusions Bone seintigraphymay be omitted in patients with clinically localized renal ceil carcinoma(stage Ⅰ,Ⅱ) unless bone pain is pres ent.Bone scintigraphy should be performed in patients with stage Ⅲ or Ⅳ regardless of symptoms.