^99mTc—MDP骨扫描在前列腺癌骨转移诊断中的价值

目的：探讨^99mTc-MDP骨扫描在前列腺痛骨转移诊断中的价值。方法：对明确诊断为前列腺癌的527例患者行^99mTc-MDP骨扫描，骨扫描不能确诊为骨转移者再经MRI、CT和病理检查等最后确诊有无骨转移。结果：在527例前列腺癌^99mTc-MDP骨扫描中，阳性显像331例，阴性显像196例；最后确诊骨转移者318例，占前列腺癌总例数的60．34％（318／527）．无骨转移者209例，占前列腺癌总例数的39．66％（209／527）。^99mTc-MDP骨扫描诊断前列腺癌骨转移的灵敏度为84．59％（269／318），特异度为70．33％（147／209），误诊率为29．67％（62／209）．漏诊率为15．4l％（49/318）．阳性预测值为81．27％（269／331），阴性预测值为75．00％（147／l96）。随着^99mTc-MDP骨扫描诊断前列腺癌骨转移病灶数量级别从I级增至Ⅱ级和Ⅲ级时，其诊断前列腺癌骨转移的准确度越来越高。结论：^99mTc-MDP骨扫描诊断前列腺癌骨转移具有微高的灵敏度、特异性、阳性预测值和阴性预测倩，误诊率和漏诊率低。随骨转移病灶级别的增加，其诊断前列腺癌有无骨转移的价值越来越大。

Value of ^99mTc-MDP bone scanning in patients with prostate cancer bone metastasis

Objective： To sludy the value of ^99mTc-MDP bone scanning in lhe patients with prostate cancer bone metastasis. Method： ^99mTc-MDP whole-body bone scanning wax performed in 527 patients with prostate cancer. The palients wilb bone melastasis were confirmed by ^99mTc-MDP whole body bone scanning, MRI, CT or pathologic diagnosis. Result： In 527 patients with prostate cancer,the positive imaging was 331 patients by ^99mTc-MDP whole-body bone scanning, and the negalive imaging was 1,96 patients. Finally, the percentage of patients with osseous metastasis was 60. 34%（318/527）, and without osseous metastasis was 39. 6%（209/527）. The sensitivity was 84. 595% （269/318） in the patiems with prostate cancer bone metastasis by ^99mTc-MDP whole-body hone scanning, and the specificity was 70.33%（ 147/209）, the mistake diagnostic rate was 29.67% （62/209）, the omission diagnostic rare was 15. 41%（49/318）, the positive prediction value was 81. 27%（269/331）, and the neg at ire predict value was 75. 00%（147/196 ）. The higher the grade of the bone metastasis was, the more accuracy of ^99mTc-MDP whole-body bone scanning showed. Conclusion： ^99mTc-MDP whole body bone scanning is a good method in diagnosis of osseous metastasis in the patients with prostate cancer, which the sensitivity, specificity, positive and negative prediction value were high, and the mistake and omission diagnostic rate were low. The higher the focus level ix the more wduable the diagnosis was reflected.