Wang Changyin, Shen Ying
Department of Nuclear Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, China.
Nucl Med Commun. 2012 Apr;33(4):379-83. doi: 10.1097/MNM.0b013e3283504528.
The aim of this study was to explore the distribution features of metastatic bony lesions in prostate cancer.
Bone scans with 99mTc-methylene diphosphonate were performed in 144 patients with pathologically proven prostate cancer, and distribution regularity of metastatic bony lesions was analyzed retrospectively.
A total of 2000 lesions of bone metastasis were detected in 102 patients, 28.9% of which were distributed in the ribs, 14.8% in thoracic vertebrae, 13.8% in the ilium, and 8.0% in the lumbar vertebrae. The distribution of metastatic bony lesions was correlated with the total number of lesions. The proportion of metastatic lesions of vertebrae and pelvis was up to 84.5% (49/58) in fewer bone metastases. The proportion gradually decreased with an increase in the total number of lesions, but the proportion of the bony lesions, except for the vertebrae and pelvis, gradually increased with an increase in the total number of lesions. Ninety-nine percent (903/912) of metastatic bony lesions, except for the vertebrae and pelvis, coexisted with metastasis of vertebrae or pelvis, whereas only 1.0% (9/912) of those were detected in no metastasis of the vertebrae and pelvis; their difference was significant (χ2=876.4, P=0.000). About 98.8% (571/578) of metastatic costal lesions coexisted with vertebrae metastasis, but only 1.2% (7/578) of these were detected in no metastasis of vertebrae; their difference was significant (χ2=550.3, P=0.000). The difference between left body and right body was not significant (χ=1.3, P=0.249).
Metastatic bony lesions of prostate cancer are located mainly in the vertebrae and pelvis in the early stage. The distribution of metastatic bony lesions is not only characterized by spreading to left body and right body randomly, but also presents the tendency of developing with orderliness to a certain extent in the whole body.
本研究旨在探讨前列腺癌骨转移瘤的分布特征。
对144例经病理证实的前列腺癌患者进行99mTc-亚甲基二膦酸盐骨扫描,并回顾性分析骨转移瘤的分布规律。
102例患者共检测到2000处骨转移病灶,其中28.9%分布于肋骨,14.8%分布于胸椎,13.8%分布于髂骨,8.0%分布于腰椎。骨转移瘤的分布与病灶总数相关。骨转移灶较少时,脊椎和骨盆转移灶的比例高达84.5%(49/58)。该比例随病灶总数增加而逐渐降低,但除脊椎和骨盆外的骨转移灶比例随病灶总数增加而逐渐升高。除脊椎和骨盆外,99%(903/912)的骨转移瘤与脊椎或骨盆转移共存,而仅1.0%(9/9I2)在无脊椎和骨盆转移时被检测到;两者差异有统计学意义(χ2=876.4,P=0.000)。约98.8%(571/578)的肋骨转移瘤与脊椎转移共存,但仅1.2%(I/578)在无脊椎转移时被检测到;两者差异有统计学意义(χ2=550.3,P=0.000)。左右侧差异无统计学意义(χ=1.3,P=0.249)。
前列腺癌骨转移瘤早期主要位于脊椎和骨盆。骨转移瘤的分布不仅表现为随机向左右侧扩散,而且在全身范围内一定程度上呈现出有序发展的趋势。