Clinical Research of Vertebral Metastasis in Lung Cancer
|School||Third Military Medical University|
|Keywords||Lung cancer Bone metastases Spine Diagnosis Bone-related events|
Objective To investigate the clinical features of lung cancer the spine bone metastasis of the advantages and disadvantages of the different imaging inspection methods in the lung cancer the spine bone metastasis diagnosis. Methods 230 cases of the lung cancer spine metastases, conducted a retrospective study of clinical data; were collected the ECT checks positive performance of the 76 cases and PET scans positive performance of the 15 cases of lung cancer spine bone metastasis, while tracing where CT, MRI, PET examination the sensitivity of the information, compare several methods, described typical cases focus. Results. Occurred spine bone metastases in patients with lung cancer most of which are in the 50 to 70-year-old age group, accounting for more than 60%, with the peak age of incidence of lung cancer is consistent. Occurrence of the spine bone metastasis of lung cancer patients with primary cancer sites to share ratio descending order of the left upper lobe (27.83%), right upper lobe (25.47%), the right lung lower lobe (21.70%) left lower lobe (16.04%), and the right middle lobe (8.96%). 3. Pathological type proportion occurrence the spine bone metastasis of lung cancer patients from high to low in the order of adenocarcinoma (60.20%), squamous cell carcinoma (25.00%), small cell lung cancer (14.29%) and large cell lung cancer (0.51%) and poorly differentiated type proportion of 72.79%. Spine bone metastasis of lung cancer patients with bone-related events (SREs) occurs most frequently for bone pain (87.83%), followed by spinal cord compression (30.87%) and pathological fractures (12.17%), the incidence of hypercalcemia very low, accounting for only 2.47%; incidence of pathological fractures of patients with more than 50-year-old age group increased significantly. 230 cases of lung cancer spine bone metastasis, a total of 30 patients with pre-misdiagnosed misdiagnosis rate was 13.04%. Misdiagnosed as hyperostosis and degeneration of the largest number of cases, eight cases of misdiagnosis rate was 3.48%, accounting for 26.67% of the number of misdiagnosed cases. Longest delays in pre-diagnostic time up to 18 months, the average pre-delay in diagnosis time of four months. 6.26 cases in hospital deaths the, T bone clinic - Death are less than 12 months. Clinic the T bone - Death <3 months, 3 ≤ T bone clinic - Death <6 months, 6 ≤ T bone clinic - Death <1 the death of three time periods in the distribution of the number of cases of a significant difference (p = 0.025 <0.05), the number of patients died within three months up to a total of 14 cases, accounting for 53.85% of the total number of deaths. 7.76 cases of lung cancer spine bone metastases in the the ECT scan-positive cases, the the MRI positive rate was 93.3%, CT positive rate was 42.5%; same inspection site than ECT, MRI detected more lesions. 8.15 cases of lung cancer spine bone metastases PET scan-positive cases, ECT, MRI sensitivity are 100%, the sensitivity of CT was 75%; PET average detection number of lesions up to $ 3.67 / cases, followed by ECT , 2.2 / cases times, MRI 1.5 / cases, CT 1 / cases; simultaneous PET and MRI, CT, ECT Joint Inspection of six patients, four cases PET examination of the lesion localization deviation. Conclusion 1.230 cases occurred spine bone metastases in patients with lung cancer most of the 50 to 70 age group; primary cancer site of the highest proportion of left upper lobe; the highest proportion of pathological type adenocarcinoma, and poorly differentiated type proportion highest; SREs occurred most frequently for pain, followed by spinal cord compression and pathologic fractures, in particular, is more than 50-year-old age group of patients with pathological fracture incidence increased significantly, the very low incidence of hypercalcemia. 2 230 cases of lung cancer spine bone metastasis, a total of 30 patients with early misdiagnosis, misdiagnosis rate was 13.04%, which was misdiagnosed as the number of cases of hyperostosis and degeneration up, the longest advance delay in diagnosis time of 18 months, the average pre-delay in diagnosis time of four months. 3.26 cases of lung cancer spine bone metastasis in hospital deaths, from the diagnosis of spinal bone from the date of transfer, the survival time of less than 1 year, and most of the survival of patients with no more than three months. 4.ECT on spine bone metastasis diagnostic sensitivity, but higher specificity of MRI examination. 5.PET than other imaging methods in the diagnosis of spinal bone metastases higher sensitivity, easy early detection of the potential spinal bone metastases, but the relative lack of anatomical localization ability to be combined with CT and MRI to confirm the diagnosis.