Kanaev S V, Novikov S N, Zhukova L A, Pozharisskiĭ K M, Leenman E E, Gershanovich M L, Tiutin L A, Shelkoplias E N
N.N. Petrov Research Institute of Oncology, Ministry of Health of the RF, St. Petersburg.
Vopr Onkol. 2000;46(6):676-81.
Diagnosis of skeletal tumors in patients with Hodgkin's disease is of paramount importance for precise staging of tumor process, prognosis and choice of optimal treatment. At present, according to the International Union Against Cancer (UICC), scintigraphy of bones and bone marrow is not regarded as a standard examination procedure for this pathology. We believe, however, that the sensitivity, specificity and overall accuracy of this procedure for bone marrow examination are 91.4; 94.8 and 92.9%, while those of osteoscintigraphy--49.1; 97 and 80.6%, respectively. According to our statistics (based on chi-square-test), the sensitivity and overall accuracy of osteoscintigraphy were significantly lower (p < 0.05) than those of bone marrow scintigraphy. The specificity (100%) of bone marrow trepanobiopsy is beyond doubt. However its sensitivity (36%) and overall accuracy (70.7%) were significantly lower (p < 0.05) than those of bone marrow scintigraphy (based on chi-square-test). Therefore, since the results of bone marrow scintigraphy are comparable to those of MRT which, like bone marrow trepanobiopsy, is a component of the diagnostic standard procedure approved by the UICC, bone marrow scintigraphy should be recommended for assaying the extent of involvement in Hodgkin's disease.
对霍奇金病患者的骨骼肿瘤进行诊断，对于准确判断肿瘤分期、预后以及选择最佳治疗方案至关重要。目前，根据国际抗癌联盟（UICC）的标准，骨骼和骨髓闪烁扫描术并不被视为针对这种病理情况的标准检查程序。然而，我们认为，该程序用于骨髓检查的敏感性、特异性和总体准确率分别为91.4%、94.8%和92.9%，而骨闪烁扫描术的相应数值分别为49.1%、97%和80.6%。根据我们的统计（基于卡方检验），骨闪烁扫描术的敏感性和总体准确率显著低于骨髓闪烁扫描术（p < 0.05）。骨髓环钻活检的特异性（100%）毋庸置疑。但其敏感性（36%）和总体准确率（70.7%）显著低于骨髓闪烁扫描术（基于卡方检验，p < 0.05）。因此，鉴于骨髓闪烁扫描术的结果与磁共振成像（MRT）相当，而MRT与骨髓环钻活检一样，是UICC批准的诊断标准程序的组成部分，故应推荐采用骨髓闪烁扫描术来测定霍奇金病的受累范围。
