Rossing N, Munck O, Nielsen S P, Andersen K W
Eur J Cancer Clin Oncol. 1982 Jul;18(7):629-36. doi: 10.1016/0277-5379(82)90208-5.
In 1978, 1012 out of a total of 1888 Danish breast cancer patients registered for a nationwide therapeutical trial were bone-scanned to find osseous metastases. A re-reading group (N.R., O.M. and S.P.N.) interpreted 842 of the scans produced in the twelve participating hospitals. Specific criteria were used for grading the scintiscans. Of the 842 scans 682 were performed within 30 days of the operation and were defined as initial. The re-reading group found 50 (7%) of these scans to be equivocal and 46 (7%) to be indicative of bone metastases at the time of operation. The number of X-ray-verified bone metastases was only 5 (0.6%). The frequency of positive bone scans correlated with the age of the patients and tumor size, but not with clinical staging at the time of operation, number of positive axillary lymph nodes or degree of tumor anaplasia. Recurrences and death rates during a 2-yr follow-Up period correlated significantly with initial clinical staging. In the clinical low-risk group a positive initial bone scan worsened the prognosis, but this was not statistically significant for all patients grouped together. Although the prognostic value of the initial bone scan per se is dubious, it serves as a guidance for elective X-ray examination and as a basis for comparing subsequent scans.
1978年，在丹麦登记参加一项全国性治疗试验的1888例乳腺癌患者中，1012例接受了骨扫描以查找骨转移。一个重新阅片小组（N.R.、O.M.和S.P.N.）对12家参与医院所做的842份扫描结果进行了解读。采用特定标准对闪烁扫描结果进行分级。在这842份扫描中，682份是在手术后30天内进行的，被定义为初始扫描。重新阅片小组发现其中50份（7%）扫描结果不明确，46份（7%）在手术时提示有骨转移。经X线证实的骨转移病例仅有5例（0.6%）。骨扫描阳性频率与患者年龄和肿瘤大小相关，但与手术时的临床分期、腋窝阳性淋巴结数目或肿瘤间变程度无关。在2年随访期内的复发率和死亡率与初始临床分期显著相关。在临床低风险组中，初始骨扫描阳性使预后变差，但对所有患者总体而言，这在统计学上并不显著。尽管初始骨扫描本身的预后价值值得怀疑，但它可为选择性X线检查提供指导，并作为比较后续扫描结果的基础。
