This paper is aimed to assess the diagnostic value of MRI versus 99Tcm-methylene diphosphonate (99Tcm-MDP) bone scan (BS) for osseous metastases in patients with prostate cancer. The computer-based retrieval was conducted on PubMed, EMBASE, EBSCO, Web of Knowledge, the Cochrane Library and Ovid data bases to search for trials about diagnosing osseous metastases of prostate cancer with MRI and 99Tcm-MDP BS. Selected with time acceptance and time exclusion criteria, the data quality were evaluated with QUADAS quality assessment tool and collected. We used the Meta-Disc software to conduct meta-analysis, and then calculated the pooled sensitivity, specificity and diagnostic odds ratio (DOR), drew the summary receiving operating characteristic (SROC) curve, and measured the area under curve (AUC) and Q* value. Then five studies were included, involving 353 patients. The pooled sensitivity of MRI and BS was 0.95 (95% CI 0.90~0.98) and 0.67 (95% CI 0.58~0.75), respectively. The pooled specificity was 0.97 (95% CI 0.94~0.99) and 0.88 (95% CI 0.83~0.91), respectively. The pooled DOR was 402.99 (95% CI 119.05~1 364.15) and 23.85 (95% CI 1.32~431.48), respectively. The AUC was 0.990 1 and 0.624 1, respectively. The Q* was 0.958 7 and 0.593 8. It can well be concluded that MRI is more effective than 99Tcm-MDP BS in the diagnosis of osseous metastases in patients with prostate cancer.
目的 探讨宫颈癌骨转移相关因素。 方法 回顾分析2008年6月－2011年8月收治的352例宫颈癌患者的临床资料，其中鳞癌326例，腺癌26例；临床分期Ⅰ期60例、Ⅱ期184例、Ⅲ期90例、Ⅳ期18例。比较不同期别、不同病理类型、不同组织分级患者的骨转移情况。 结果 352例宫颈癌中有18例发现骨转移，转移率为5.1%；转移时间为3～48个月，2例于骨转移后1年内死亡。鳞癌326例，骨转移率为5.2%；腺癌26例，骨转移率为3.8%。Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者的骨转移率分别为0.0%、3.8%、5.6%和33.3%，晚期与早期相比有统计学意义（P＜0.05）；高、中和低分化患者骨转移率分别为3.1%、3.1%和6.3%，高分化与中分化相比，差异无统计学意义（P＞0.05），低分化与高中分化相比差异有统计学意义(P＜0.05)。 结论 宫颈癌骨转移与宫颈癌临床分期、病理类型、细胞分级密切相关。在宫颈癌的治疗过程中，做到早发现、早治疗，可提高患者的治疗效果，延长生存时间。
According to the inclusion and exclusion criteria, we searched for relevant original articles in some big Chinese and English databases.The qualities of the studies were evaluated with QUADAS quality assessment tool. A software program, Meta-disc, was used to obtain the pooled estimates and heterogeneity test for sensitivity, specificity, SROC curve, and so on. Finally the 17 article were included. On a per-patient basis, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), Q*, SROC area under curve for 99mTc-MDP bone scan and computed tomography (CT) were 0.87 and 0.99, 0.81 and 0.98, 3.88 and 13.86, 0.2 and 0.03, 27.73 and 612.17, 0.8418 and 0.9732, 0.9097 and 0.9952, respectively. On a per-focus basis, the pooled SEN, SPE, LR+, LR-, DOR, Q*, SROC area under curve for 99mTc-MDP bone scan was 0.86, 0.97, 13.32, 0.16, 102.4, 0.8944, 0.9528, respectively. For CT, only 1 article were included. This paper demonstrate: whether 99mTc-MDP or CT both have high diagnostic efficiency for bone metastase of breast cancer.
摘要:目的:探讨血清CA153和BAKP在乳腺癌骨转移显像诊断中的应用。方法:对92例乳腺癌患者的核素骨显像结果、血清CA153和BAKP结果进行回顾性研究。结果:①血清CA15-3和B-AKP的值随着骨转移分期的增高而逐步升高,且差异显著(Plt;0. 01);②血清CA15-3和B-AKP与骨转移的数目呈正相关;③血清CA15-3gt;25 U/mL时,骨转移的阳性率为63.3%,血清CA15-3lt;25 U/mL时,骨转移的阴性预测值为94. 5%;血清B-AKPgt;20 U/L时,骨转移的阳性率为59. 6%时,骨转移的阴性预测值为73.5%;当血清CA15-3lt;25 U/mL同时B-AKPlt;20 U/L时,骨转移的阴性预测值为100%。结论:血清CA15-3和BAKP测定在乳腺癌骨显像诊断中具有重要的应用价值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.
ObjectiveTo study the influence of estrogen on zoledronic acid in preventing bone metastasis of breast cancer. MethodsTwo hundred and sixteen breast cancer patients who accepted modified radical mastectomy, chemotherapy, and the prophylaxis of zoledronate acid from January 2006 to December 2009 in this hospital were collected, including luminal A 55 cases, luminal B 63 cases, HER-2 positive 50 cases, triple negative 48 cases. Then these patients were categorized into low estrogen group(n=39) and normal estrogen group(n=177) according to the estrogen level. The patients in the low estrogen group accepted drug induced menopause, in the normal estrogen group didn't accept drug induced menopause. All the patients accepted the therapy of zoledronate acid, then with clinical follow-up for 3-5 years until progressive disease(include neoplasm recurrence, bone metastasis, and other neoplasm metastasis etc.). ResultsThe rate of bone metastasis in the low estrogen group was significantly lower than that in the normal estrogen group (χ2=21.91, P < 0.05). For the patients with luminal A, luminal B, HER-2 positive, and triple negative, the rates of bone metastases in the low estrogen group were significantly lower than those in the normal estrogen group[luminal A:5.13%(2/39) versus 12.43%(22/177), χ2=4.54, P < 0.05;luminal B:7.69%(3/39) versus 13.56%(24/177), χ2=6.04, P < 0.05;HER-2 postive:2.56%(1/39) versus 15.25%(27/177), χ2=3.95, P < 0.05;triple negative:2.56% (1/39) versus 18.08%(32/177), P < 0.05]. The rate of bone metastasis among the different subtype of breast cancer in the low estrogen group was not significant difference(χ2=0.55, P > 0.05). ConclusionsFrom the limited preliminary data, the premenopausal women patients with breast cancer who accepted drug induced menopause afer application of zoledronate acid for preverttion of bone metastasis has a obviously efficacy, and the efficacy has no difference among four molecular subtypes of breast cancer.
ObjectiveTo find the hub genes related to bone metastasis of breast cancer by weighted geneco-expression network analysis (WGCNA) method, and provide theoretical support for the development of new targeted therapeutic drugs.MethodsThe basic clinical features of 286 breast cancer patients and the gene expression information of tumor specimens were downloaded from the GSE2034 dataset from the Gene Expression Omnibus. R software was used to analyze the gene microarray. The WGCNA package embedded in the R software was used for various analysis in weighted correlation network analysis. Cox proportional hazard regression was performed by using SPSS software.ResultsThe top one quarter genes with the greatest variance variability were selected by WGCNA, and a total of 5 000 genes were used for further enrichment analysis. Finally, 15 gene co-expression modules were constructed, and the magenta module (r=0.94, P<0.001) was significantly positively correlated with bone metastasis of breast cancer. It was further found that six hub genes highly associated with bone metastasis in the magenta module were: Ral GTPase-activating protein subunitalpha-1 (RALGAPA1), B-cell antigen receptor complex-associated protein alpha chain (CD79A), immunoglobulin kappa chain C region (IGKC), arrestin beta 2 (ARRB2), differentially expressed in FDCP 6 homolog (DEF6), and immunoglobulin lambda variable 2 (IGLV2).ConclusionWe found that RALGAPA1, CD79A, IGKC, ARRB2. DEF6, and IGLV2 may play an important role in bone metastasis of breast cancer.
ObjectiveTo discuss related clinical research progress of bone metastasis of breast cancer. MethodThe literatures about bone metastases of breast cancer were researched and reviewed. ResultsAlthough there were so many related researches at home and abroad for bone metastasis of breast cancer,but the specific mechanism was still not fully elucidated.At present,the diagnostic method of bone metastasis of breast cancer included X-ray examination,bone scanning,computer tomography,magnetic resonance imaging,positron tomography,positron emission computed tomography,pathology biopsy,and detection of serum markers.In clinical treatment,the treatment consisted of systemic therapy and local therapy,but there was no uniform standard. ConclusionFor high incidence and serious influence on quality of life,bone metastasis of breast cancer needs to be studied further.
目的:为肿瘤骨转移患者压疮预防的方法进行总结评价以达到对临床肿瘤压疮进行指导。方法:采用改良后的诺顿评估表（信度0.80，效度0.84）作为压疮易患患者评估工具。评估内容包括患者年龄、身体状况、意识、活动能力、运动受限情况、疼痛、皮肤情况、大小便失禁、饮食、进食能力、口腔情况、牙齿及患者血色素、蛋白等资料。评估时间从患者入院开始，对30例肿瘤全身多处骨转移患者进行评估，有预见性、计划性，针对性及个体化对患者制订护理计划及措施，并督促实施，对效果进行评价分析。结果:≤25分高危险性患者（难以避免）发生率50％，26～29分中度危险性患者（可避免）发生率0，≥30分低危险性患者发生率14.2％。效果评价:压疮预防评估对肿瘤骨转移患者压疮的预防是有效的，压疮评估有助于规范护理行为和护理管理；通过分析找出护理过程中的薄弱环节，以利于指导临床工作。