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儿童恶性肿瘤骨髓累及:正电子发射断层扫描计算机断层扫描与骨髓活检的对比研究。

Bone marrow involvement in pediatric malignancies: a comparison study of Positron emission tomographycomputed tomography and bone marrow biopsy.

机构信息

Departments of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey.

出版信息

Turk J Pediatr. 2020;62(2):182-190. doi: 10.24953/turkjped.2020.02.003.

Abstract

BACKGROUND AND OBJECTIVES

The comparison of Positron emission tomography- computed tomography (PETCT) and bone marrow biopsy (BMB) modalities in detecting bone marrow disease is an up to date research topic. In this study, we aimed to compare the results of PET-CT and BMB procedures in detecting bone marrow involvement in pediatric malignancies.

METHOD

At the time of diagnosis, PET-CT imaging and BMB performed patients` data were evaluated, retrospectively. Malign diagnoses were Hodgkin's lymphoma in 23 (30.7%), non-Hodgkin's lymphoma in 20 (26.7%), neuroblastoma in 11 (14.7%), Ewing sarcoma in 10 (13.7%), Langerhans cell histiocytosis in 6 (8%), and rhabdomyosarcoma in 5 (6.6%) patients.

RESULTS

Bone marrow involvement was detected in 39 (52%) of 75 patients. Bone marrow involvement was identified by both PET-CT and BMB in 18 (46.1%) patients, by only PET-CT in 12 (30.7%) patients, by only BMB in 9 (23%) patients. The sensitivity of PET-CT was 66%, specificity was 75%, positive predictive value was 60%, and negative predictive value was 80%. Sensitivity, spesificity, positive and negative predictive values of PETCT were different in before mentioned malignancy groups.

CONCLUSION

PET-CT may not have high sensitivity and specificity to identify bone marrow involvement for each type of cancer. The approach of using bone marrow biopsy and PET-CT as complementary modalities seems reliable.

摘要

背景与目的

正电子发射断层扫描-计算机断层扫描(PET-CT)与骨髓活检(BMB)在检测骨髓疾病方面的比较是一个最新的研究课题。本研究旨在比较 PET-CT 和 BMB 检查在检测儿科恶性肿瘤骨髓受累中的结果。

方法

在诊断时,回顾性评估了 PET-CT 成像和 BMB 检查患者的数据。恶性诊断为霍奇金淋巴瘤 23 例(30.7%),非霍奇金淋巴瘤 20 例(26.7%),神经母细胞瘤 11 例(14.7%),尤文肉瘤 10 例(13.7%),朗格汉斯细胞组织细胞增生症 6 例(8%),横纹肌肉瘤 5 例(6.6%)。

结果

75 例患者中有 39 例(52%)骨髓受累。18 例(46.1%)患者通过 PET-CT 和 BMB 均发现骨髓受累,12 例(30.7%)患者仅通过 PET-CT 发现骨髓受累,9 例(23%)患者仅通过 BMB 发现骨髓受累。PET-CT 的灵敏度为 66%,特异性为 75%,阳性预测值为 60%,阴性预测值为 80%。在上述恶性肿瘤组中,PET-CT 的灵敏度、特异性、阳性预测值和阴性预测值均不同。

结论

PET-CT 可能无法针对每种类型的癌症均具有较高的灵敏度和特异性来识别骨髓受累。采用骨髓活检和 PET-CT 作为互补方法的方法似乎是可靠的。

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