Blacher E, Johnson D E, Haynie T P
Urology. 1985 Nov;26(5):432-4. doi: 10.1016/0090-4295(85)90148-7.
Radionuclide bone scans were obtained as part of the routine evaluation of 85 patients with renal cell carcinoma. Twenty-nine patients (34%) were found to have metastatic disease at presentation. Bone scans were abnormal in 27 of these 29 patients for a sensitivity of 93 per cent; of the remaining 56 without metastatic disease, 48 had normal bone scans for a specificity of 86 per cent. In all patients whose abnormal bone scans indicated metastatic disease, there were either clinical signs (bone pain), laboratory findings (elevated alkaline phosphatase), or routine radiographic procedures (chest roentgenogram, intravenous pyelogram, or angiogram) suggesting disease metastatic to bone. Although bone scanning was useful for confirming clinically or radiographically suspected metastatic disease, it did not influence the staging of the renal cell carcinoma in any patient. We therefore conclude that bone scans should be used to confirm the presence and to determine the extent of osseous metastases in patients with renal cell carcinoma but are unnecessary as a routine staging procedure.
对85例肾细胞癌患者进行常规评估时进行了放射性核素骨扫描。29例（34%）患者在初诊时被发现有转移性疾病。这29例患者中有27例骨扫描异常，敏感性为93%；其余56例无转移性疾病的患者中，48例骨扫描正常，特异性为86%。在所有骨扫描异常提示有转移性疾病的患者中，均有临床体征（骨痛）、实验室检查结果（碱性磷酸酶升高）或常规影像学检查（胸部X线片、静脉肾盂造影或血管造影）提示有骨转移。虽然骨扫描有助于确诊临床或影像学怀疑的转移性疾病，但对任何患者的肾细胞癌分期均无影响。因此，我们得出结论，骨扫描应用于确诊肾细胞癌患者骨转移的存在并确定其范围，但作为常规分期检查并无必要。
