骨外软组织肿瘤骨显像时显影与组织细胞学类型的关系

摘要

目的 探讨99Tcm-亚甲基二膦酸盐(MDP)骨显像时骨外恶性肿瘤组织显影与组织细胞学类型的关系.方法 收集31例骨显像时骨外恶性肿瘤组织显影的患者资料,观察病灶区放射性浓聚程度,按放射性从低到高划分为"+"、"++"和"+++".利用感兴趣区(ROI)技术分别勾画显影肿块(T)和相应正常软组织(NT)边界,计算其放射性(T/NT)比值.结合组织细胞学类型进行分析.对定量资料数据进行t检验、确切概率法及等级成组资料的秩和检验.结果 31例中有7例恶性肿瘤显影为"+",占22.6%,其中鳞状细胞癌4例,腺癌3例;有22例为"++",占71.0%,其中恶性纤维组织细胞瘤、小细胞肺癌各1例,鳞状细胞癌3例,腺癌17例;有2例显影为"+++",占6.5%,均为腺癌.7例鳞状细胞癌T/NT比值为3.50±1.74,22例腺癌T/NT比值为5.96±2.20,腺癌放射性明显高于鳞状细胞癌,两者之间差异有统计学意义(t=2.70,P＜0.05).中分化和低分化肿瘤99Tcm-MDP浓聚程度之间差异无统计学意义(Uc=1.93,P＞0.05).结论 骨显像时软组织恶性肿瘤显影腺癌较鳞状细胞癌多见,且腺癌99Tcm-MDP的浓聚程度高于鳞状细胞癌.恶性肿瘤99Tcm-MDP不同的浓聚程度与其分化程度无明显关系.%Objective Some extraosseous soft tissue tumors(EOST)could take up99Tcm-methylene diphosphonic acid(MDP).The aim of this study was to analyze the correlation between EOST visualized in bone scintigraphy and tumor pathology.Methods Thirty-one patients with EOST were recruited into this study.Their99Tcm-MDP bone scintigraphy images were retrospectively studied.The uptake levels were graded as low.medium and high.Regions of interest(ROIs)over tumor and normal tissue were drawn and their uptake ratio(T/NT)were calculated.The t test was used to analyze the quantitative data and the exact propability and the rank sum test were used to analyze other data.Results Seven of 31(22.6%) malignant tumors had low tracer uptake.including 4 squamous cell carcinomas(SCC).3 adenocarcinomas.Twenty-two cases(71.O%)had medium uptake,including 1 small cell lung carcinoma,1 malignant fibrous histiocytoma,3 SCC,17 adenoearcinomas.Two(6.5%)lesions of high uptake were all adenocarcinomas.The T/NT ratio of adenocarcinoma was significantly higher than that of SCC(5.96±2.20 vs 3.50±1.74.t=2.70.P＜0.05).There was no significant uptake difference between moderately and poorly differentiated tumors(Uc=1.93,P ＞0.05).Conclusion Extraosseous uptake of99Tcm-MDP is more common in adenocarcinoma but there iS no correlation between the uptake level of99Tcm-MDP and tumor cell differentiation.