Kennedy H, Kennedy N, Barclay M, Horobin M
Department of Surgery, Ninewells Hospital and Medical School, Dundee, UK.
Clin Oncol (R Coll Radiol). 1991 Mar;3(2):73-7. doi: 10.1016/s0936-6555(05)81166-5.
A total of 110 consecutive females who presented in 1987 with primary carcinoma of the breast were staged according to the UICC TNM staging system. Of these, 90 patients had bone scans at presentation, of which seven were positive. The rate of positive initial scans for Stages I-II was 3.5%. Of these only one patient subsequently had bone metastases confirmed, to diagnose which by bone scan, the estimated cost was pounds 1300. Follow-up information was obtained for 95 patients, repeat scans being performed in 22 who had symptoms suggestive of bone metastases. Ten patients with negative initial scans converted to scan-positive within a mean time of 15 months. Only four of these had radiological confirmation of bone metastases. The cost of detecting bone metastases by follow-up scan was approximately pounds 80 per patient. The false-positive rate and the false-negative rate were both calculated as 10%. The specificity of the test was calculated as 90%. It is recommended that bone scanning should be reserved for patients with Stages III and IV disease and to evaluate symptoms suggesting bone metastases.
1987年共有110例连续的原发性乳腺癌女性患者，根据国际抗癌联盟（UICC）TNM分期系统进行分期。其中，90例患者在初诊时进行了骨扫描，7例呈阳性。I-II期患者初诊扫描阳性率为3.5%。这些患者中只有1例随后被确诊为骨转移，通过骨扫描诊断的估计费用为1300英镑。获取了95例患者的随访信息，22例有骨转移症状提示的患者进行了重复扫描。初诊扫描阴性的10例患者在平均15个月内转为扫描阳性。其中只有4例经放射学证实有骨转移。通过随访扫描检测骨转移的费用约为每位患者80英镑。假阳性率和假阴性率均计算为10%。该检查的特异性计算为90%。建议骨扫描应仅用于III期和IV期疾病患者以及评估提示骨转移的症状。
