放射性核素骨显像在鼻咽癌患者中的应用价值
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摘要
目的探讨放射性核素骨显像在鼻咽癌患者中的应用价值。方法选取2016年2月至2018年2月间昆明医科大学第三附属医院收治的49例鼻咽癌患者,均在入院3d内接受常规核素骨显像检查,对鼻咽癌骨转移的影响因素进行单因素和多因素分析,统计鼻咽癌患者生存情况。结果患者中有骨转移17例(34.7%)。单因素Logistic分析,鼻咽癌骨转移的影响因素包括性别、临床分期、功能状态(KPS)评分和碱性磷酸酶(AKP)(P<0.05),不包括年龄、肿瘤T分期、肿瘤N分期、血红蛋白(Hb)、病理类型和家族史(P>0.05)。多因素Logistic分析,鼻咽癌骨转移的影响因素包括性别、年龄和临床分期(P<0.05),不包括AKP(P>0.05)。患者1年、2年和3年生存率分别为93.9%、85.7%和79.6%,其中骨转移患者1年、2年和3年生存率(88.2%、82.4%和70.6%)均低于未转移患者(96.9%、87.5%和84.4%)(P<0.05)。结论放射性核素骨显像在鼻咽癌患者中的应用价值高。
Objective To explore the application value of radionuclide bone imaging in nasopharyngeal carcinoma patients. Methods A total of 49 patients with nasopharyngeal carcinoma who received conventional radionuclide bone scintigraphy within 3 d after admission to Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital from February 2016 to February 2018 were selected. Then the factors affecting metastasis of nasopharyngeal carcinoma were studied by univariate analysis and multivariate analysis. The survivals in patients with nasopharyngeal carcinoma were statistically analyzed. Results Bone metastases occurred in 17 patients,and the metastasis rate was 34. 7%. Univariate Logistic analysis showed that the factors influencing bone metastasis of nasopharyngeal carcinoma included gender,age,clinical staging,Karnofsky performance score,and alkaline phosphatase( AKP)( P < 0. 05) rather than pathological type,T staging,N staging,hemoglobin( Hb),and family history( P > 0. 05). Multivariate Logistic analysis showed that the factors influencing bone metastasis of nasopharyngeal carcinoma involved gender,age,and clinical staging( P < 0. 05) instead of AKP( P > 0. 05). The 1-,2-,and 3-year survival rates were 93. 9%,85. 7% and 79. 6% respectively for patients with nasopharyngeal carcinoma. The 1-,2-and3-year survival rates were 88. 2%,82. 4% and 70. 6% for patients with bone metastases which were significantly lower than in patients without metastasis( 96. 9%,87. 5%,and 84. 4%,respectively)( all P <0. 05). Conclusion Radionuclide bone imaging is of high value in nasopharyngeal carcinoma patients.
Objective To explore the application value of radionuclide bone imaging in nasopharyngeal carcinoma patients. Methods A total of 49 patients with nasopharyngeal carcinoma who received conventional radionuclide bone scintigraphy within 3 d after admission to Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital from February 2016 to February 2018 were selected. Then the factors affecting metastasis of nasopharyngeal carcinoma were studied by univariate analysis and multivariate analysis. The survivals in patients with nasopharyngeal carcinoma were statistically analyzed. Results Bone metastases occurred in 17 patients,and the metastasis rate was 34. 7%. Univariate Logistic analysis showed that the factors influencing bone metastasis of nasopharyngeal carcinoma included gender,age,clinical staging,Karnofsky performance score,and alkaline phosphatase( AKP)( P < 0. 05) rather than pathological type,T staging,N staging,hemoglobin( Hb),and family history( P > 0. 05). Multivariate Logistic analysis showed that the factors influencing bone metastasis of nasopharyngeal carcinoma involved gender,age,and clinical staging( P < 0. 05) instead of AKP( P > 0. 05). The 1-,2-,and 3-year survival rates were 93. 9%,85. 7% and 79. 6% respectively for patients with nasopharyngeal carcinoma. The 1-,2-and3-year survival rates were 88. 2%,82. 4% and 70. 6% for patients with bone metastases which were significantly lower than in patients without metastasis( 96. 9%,87. 5%,and 84. 4%,respectively)( all P <0. 05). Conclusion Radionuclide bone imaging is of high value in nasopharyngeal carcinoma patients.
引文
[1]张汝森,冯勇,胡颖坚,等.骨显像与MRI对鼻咽癌脊柱转移瘤的诊断价值对比[J].国际医药卫生导报,2011,17:1303-1304.
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[9]朱小东,黄志碧,曲颂,等.鼻咽癌后程加速超分割放射治疗的循征医学研究[J].中国肿瘤临床与康复,2008,15:16-20.
[10]叶伟军,闵华庆,曹新平,等.外周血淋巴细胞松胞素阻滞微核法预测鼻咽癌放射敏感性的临床和实验研究[J].中国肿瘤临床与康复,2007,14:481-486.
[11]花永虹,陈晓钟.复发性鼻咽癌再程放射治疗中脑干剂量控制相关研究进展[J].实用肿瘤杂志,2015,30:113-115.
[12]He YQ,Xue WQ,Xu FH,et al.The relationship between environmental factors and the profile of epstein-barr virus antibodies in the lytic and latent infection periods in healthy populations from endemic and non-endemic nasopharyngeal carcinoma areas in China[J].EBio Medicine,2018,30:184-194.
[13]Finazzi T,Rordorf T,Ikenberg K,et al.Radiotherapy-induced anti-tumor immune response and immune-related adverse events in a case of recurrent nasopharyngeal carcinoma undergoing anti-PD-1 immunotherapy[J].BMC Cancer,2018,18:395.
[2]陈端振,唐明灯,倪雷春,等.肥大性肺性骨关节病60例核素骨显像特征分析[J].福建医药杂志,2012,34:129-131.
[3]薛红.放射性核素全身骨显像诊断骨转移的临床价值[J].青海医药杂志,2011,41:67-68.
[4]贾莉,马世兴.52例恶性肿瘤患者的放射核素骨显像初步分析[J].亚太传统医药,2008,4:38-39.
[5]张晓辉,彭祖光,周路,等.516例恶性肿瘤核素全身骨显像分析[J].国际医药卫生导报,2008,14:51-52.
[6]李卉,谢传淼,李建鹏,等.骨显像与MRI对鼻咽癌脊柱转移瘤诊断的对比观察[J].中国医学影像技术,2009,25:2279-2281.
[7]唐爽,李素芳,林灿洁.鼻咽癌患者放射性核素骨显像分析[J].中国癌症防治杂志,2009,1:159-160.
[8]邱素芳,潘建基,唐明灯,等.鼻咽癌343例放射性核素骨显像的临床分析[J].肿瘤研究与临床,2008,20:331-333.
[9]朱小东,黄志碧,曲颂,等.鼻咽癌后程加速超分割放射治疗的循征医学研究[J].中国肿瘤临床与康复,2008,15:16-20.
[10]叶伟军,闵华庆,曹新平,等.外周血淋巴细胞松胞素阻滞微核法预测鼻咽癌放射敏感性的临床和实验研究[J].中国肿瘤临床与康复,2007,14:481-486.
[11]花永虹,陈晓钟.复发性鼻咽癌再程放射治疗中脑干剂量控制相关研究进展[J].实用肿瘤杂志,2015,30:113-115.
[12]He YQ,Xue WQ,Xu FH,et al.The relationship between environmental factors and the profile of epstein-barr virus antibodies in the lytic and latent infection periods in healthy populations from endemic and non-endemic nasopharyngeal carcinoma areas in China[J].EBio Medicine,2018,30:184-194.
[13]Finazzi T,Rordorf T,Ikenberg K,et al.Radiotherapy-induced anti-tumor immune response and immune-related adverse events in a case of recurrent nasopharyngeal carcinoma undergoing anti-PD-1 immunotherapy[J].BMC Cancer,2018,18:395.