Sundram F X, Chua E T, Goh A S, Toh H J, Khor T H, Chua E J
Department of Nuclear Medicine, Singapore General Hospital.
Clin Radiol. 1990 Sep;42(3):166-9. doi: 10.1016/s0009-9260(05)81926-9.
One hundred and forty-three patients (Group 1) with histologically proven nasopharyngeal-carcinoma (NPC) had bone scintigraphy with 99Tcm methylenediphosphonate (MDP) or dihydroxypropanediphosphonate (DPD) within 2 months of the initial diagnosis. A further 162 patients (Group 2) had bone scans during the course of follow-up if there were symptoms of bone pain or evidence of metastases at other sites. Twenty-three per cent (33/143) of the newly diagnosed NPC patients (Group 1) had evidence of bone metastases. Of these 143 patients, 101 were T0-T2, 16 were T3 and 25 were T4. Thirty-six patients had no neck nodes (NO), 44 were N1, 25 N2 and 38 N3. Of the 162 patients in Group 2, 96 (59%) had a positive bone scan. The commonest sites for bony metastases from NPC were the spine, ribs, pelvis and lower limbs in order of frequency. There is a highly significant association with the nodal stage but no association with the UICC T staging which is not adequate in nasopharyngeal carcinoma. In our part of the world, bone metastases from NPC are a common cause of an abnormal bone scan.
143例经组织学证实为鼻咽癌（NPC）的患者（第1组）在初次诊断后2个月内接受了用99锝亚甲基二膦酸盐（MDP）或二羟丙基二膦酸盐（DPD）进行的骨闪烁显像。另外162例患者（第2组）在随访过程中若出现骨痛症状或其他部位有转移证据时接受了骨扫描。新诊断的鼻咽癌患者（第1组）中有23%（33/143）有骨转移证据。在这143例患者中，101例为T0-T2期，16例为T3期，25例为T4期。36例无颈部淋巴结转移（N0），44例为N1，25例为N2，38例为N3。在第2组的162例患者中，96例（59%）骨扫描呈阳性。鼻咽癌骨转移最常见的部位依次为脊柱、肋骨、骨盆和下肢。骨转移与淋巴结分期高度相关，但与UICC T分期无关，UICC T分期在鼻咽癌中并不适用。在我们所在的地区，鼻咽癌骨转移是骨扫描异常的常见原因。
