对肺癌乳腺癌和前列腺癌早期骨转移的诊断研究

目的 探讨早期明确恶性肿瘤骨转移的最佳组合。方法 选择35倒骨良性病变患者作为对照组，102例原发性肺癌、乳腺癌和前列腺癌患者作为实验组。用酶法检测血清碱性磷酸酶（ALP）；用麦胚凝集素法检测血清骨性磷酸酶（B—ALP）；用单光子计算机断层扫描仪（SPECT）进行全身核素骨显像的同时，测定血清ALP、B-ALP结果102例恶性肿瘤骨转移率62．8％，其中单发灶21．8％，多发灶78．2％：实验组和对照组ALP比较，差异有显著意义（P〈0．05），B-ALP比较，差异有极显著意义（P〈0．01）；多发灶骨转移患者ALP、B-ALP浓度明显高于单发灶患者（P〈0．01）；B-ALP〉20U／L时，对恶性肿瘤骨转移有一定的诊断价值。结论 同时测定血清B-ALP有助于明确恶性肿瘤患者核素骨显像异常表现的病变性质，可提高早期骨转移的诊断率和诊断符合率。

Study on early diagnosis of bone-metastasis of lung, breast and prostate carcinoma

Objective To study the early diagnosis method for bone-metastasis of lung, breast and prostate carcinoma. Methods A total of 102 patients with lung, breast and prostate carcinoma were selected into the study and 35 patients with benign ill selected as controls. The whole-body bone scintigraphy was performed on them by SPECT, and before that their blood samples were collected to measure the serum concentrations of ALP and B-ALP. Results The bone metastasis rate was 62.8%, including single spot (21.8%) and multi spots (78.2%). There was a highly significant difference of ALP concentration and a highly significant difference of B-ALP between the carcinoma and benignant groups. Furthermore, thepatients with multi spot bone metastasis had higher concentration of ALP and B-ALP(P<0.01). B-ALP had certain value to confirm the malign bone-metastasis when its concentration was more than 20 U/L. Conclusions It is more accurately and fully reflecting the bone-metastasis character to measure serum ALP and B-ALP and perform SPECT whole-body bone scintigraphic examination at the same time.