Nakano S, Hasegawa Y, Ibuka K, Hashizume T, Noguchi A, Imaoka S, Komatsubara Y
Department of Nuclear Medicine, Center for Adult Diseases, Osaka.
Kaku Igaku. 1993 Sep;30(9):1049-54.
Among the patients who were examined with bone scintigraphy between April 1985 and March 1991, there were 27 patients whose initial clinical manifestation was bone metastasis and who were surveyed for the primary tumor site. The primary tumor site could be identified in 20 patients (74%), consisting of 9 patients with lung cancer, 3 with prostate cancer, 3 with hepatoma, 2 with renal cancer, and one each with thyroid cancer, adrenal cancer, and pleural malignant mesothelioma. In 17 of the 20 patients, the primary site had been detected within two months after presentation. Examinations which were helpful in identifying the primary site included chest radiography, sputum cytology, abdominal sonography, serum prostatic acid phosphatase level and pathologic examination of biopsy specimens. 99mTc-PMT scintigraphy was useful in the diagnosis of the hepatoma when accumulation was observed at the metastatic sites. In 2 patients, lung cancer had been recognized using follow-up chest radiography 3 and 6 months after presentation, respectively. One patient was diagnosed at autopsy as having adrenal cancer. In 7 patients the primary site remains unknown. Histology examination of the biopsy specimen performed in 6 of these patients revealed 4 to be adenocarcinoma and 2 undifferentiated carcinoma. The average survival period of the 17 patients who died was 9.5 months. Four patients are alive, and the outcome in the remaining 6 could not be determined.
在1985年4月至1991年3月期间接受骨闪烁扫描检查的患者中，有27例最初临床表现为骨转移并接受了原发肿瘤部位的检查。20例（74%）患者可确定原发肿瘤部位，其中肺癌9例、前列腺癌3例、肝癌3例、肾癌2例、甲状腺癌、肾上腺癌和胸膜恶性间皮瘤各1例。20例患者中有17例在就诊后两个月内检测到原发部位。有助于确定原发部位的检查包括胸部X线摄影、痰细胞学检查、腹部超声检查、血清前列腺酸性磷酸酶水平及活检标本的病理检查。当在转移部位观察到放射性浓聚时，99mTc-PMT闪烁扫描对肝癌诊断有用。2例患者分别在就诊后3个月和6个月通过胸部X线摄影随访确诊为肺癌。1例患者尸检诊断为肾上腺癌。7例患者的原发部位仍不清楚。其中6例患者活检标本的组织学检查显示4例为腺癌，2例为未分化癌。17例死亡患者的平均生存期为9.5个月。4例患者存活，其余6例的结局无法确定。
