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[通过丹麦乳腺癌协作组(DBCG)系统随访计划实现放射学诊断的合理化收益。1]

[Rationalization profits of radiographic diagnosis with systematic follow-up DBCG (Danish Breast Cancer Cooperative Group) programs. 1].

作者信息

Thomsen H S, Andersen J A, Andersen K W, Axelsson C K, Blichert-Toft M, Dombernowsky P, Hansen M, Krag C, Mouridsen H T, Overgaard M

机构信息

Finseninstitutet, Rigshospitalet, København.

出版信息

Ugeskr Laeger. 1991 Aug 12;153(33):2270-2.

PMID:1781044
Abstract

In the follow-up programme of the DBCG-77 control and treatment protocols for primary operable breast cancer, bone scintigraphy and chest X-ray were performed 6 months after surgery and thereafter yearly until the diagnosis of any recurrence or another cancer. In the present study, the value of the two examinations was examined to the 6th year control. As a result of a low incidence of primary recurrence to the bone (0.6-3.9%) and to the chest (0.0-3.0%) the value was found to be low. About two thirds of the patients with primary chest recurrence addressed themselves with or had at the time of control pulmonary symptoms. About one half of those patients, in whom (during a 12-month period after the scheduled bone scintigraphy) bone metastases were diagnosed by another method, had a normal scheduled bone scintigraphy. False positive changes were not infrequent, especially at the bone scintigraphies. The diagnosis of asymptomatic chest recurrence did not reduce the mortality among stage II patients, among whom the greatest value of the control examination was found. It is concluded, that systematic use of bone scintigraphy and chest X-ray is not justified in a follow-up programme for stage I and II breast cancer patients.

摘要

在丹麦乳腺癌协作组(DBCG)-77原发性可手术乳腺癌控制与治疗方案的随访计划中,术后6个月进行骨闪烁显像和胸部X线检查,此后每年进行一次,直至诊断出任何复发或其他癌症。在本研究中,对这两项检查至第6年对照的价值进行了评估。由于骨原发性复发(0.6%-3.9%)和胸部原发性复发(0.0%-3.0%)的发生率较低,发现其价值不大。约三分之二的原发性胸部复发患者在对照时出现或有肺部症状。在那些(在预定的骨闪烁显像后12个月内)通过其他方法诊断出骨转移的患者中,约有一半的患者预定的骨闪烁显像结果正常。假阳性改变并不少见,尤其是在骨闪烁显像中。无症状胸部复发的诊断并未降低II期患者的死亡率,而在II期患者中对照检查的价值最大。得出的结论是,对于I期和II期乳腺癌患者的随访计划,系统使用骨闪烁显像和胸部X线检查是不合理的。

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