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[骨闪烁扫描术在乳腺癌术前分期判定中的应用]

[Bone scintigraphy in the preoperative determination of the stage of breast cancer].

作者信息

Denisov L E, Iarygin L M, Ermolaeva E V, Zhuravleva L I

出版信息

Med Radiol (Mosk). 1984 Jul;29(7):5-8.

PMID:6087080
Abstract

As for the frequency of metastases to the bones breast cancer ranks third among all tumors, as for the general frequency of metastases it ranks first (25-45%). Early diagnosis of breast cancer metastases to the bones using scintigraphy of the skeleton in the preoperative period gives an opportunity to reveal tumor dissemination and to provide adequate treatment without imposing on patients inappropriate therapeutic measures. The study was performed using 99mTc-pyrophosphate. In revealing the foci of high activity accumulation by more than 20% as compared to symmetrical or adjacent zones, the changes were looked upon as metastatic ones. Out of 85 patients foci of high activity accumulation in the skeleton were noted in 7 (8.3%). In 5 patients, metastases were confirmed directly on roentgenography, and in 2 patients, they manifested themselves 2 and 5 months later. Stage I-IIa disease was observed in 48 (56.5%) out of the 85 patients. Out of the 40 patients with Stage I disease, skeletal metastases confirmed by x-ray were found in 2. All 7 patients were given together with mastectomy adjuvant treatment. Thus scintigraphy of the skeleton together with chest x-ray, liver scintigraphy, physical examination and palpation should become obligatory in the preoperative examination of patients to specify breast cancer stage.

摘要

就骨转移的发生率而言,乳腺癌在所有肿瘤中位列第三,而就转移的总体发生率而言则位居第一(25%-45%)。术前利用骨骼闪烁扫描术对乳腺癌骨转移进行早期诊断,有机会发现肿瘤播散情况,并能在不采取不恰当治疗措施的前提下为患者提供充分治疗。本研究使用99m锝-焦磷酸盐进行。若发现高活性聚集灶相较于对称或相邻区域高出20%以上,则将这些变化视为转移性变化。在85例患者中,有7例(8.3%)骨骼出现高活性聚集灶。5例患者经X线检查直接确诊为转移,2例患者分别在2个月和5个月后出现转移症状。85例患者中有48例(56.5%)处于I-IIa期疾病。在40例I期疾病患者中,经X线确诊有2例发生骨骼转移。所有7例患者均在乳房切除术后接受辅助治疗。因此,骨骼闪烁扫描术连同胸部X线检查、肝脏闪烁扫描、体格检查和触诊应成为术前检查患者以明确乳腺癌分期的必要手段。

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