Study On Relationship Between The Radionuclide Bone Imaging Appearance And The Differentiation Of TCM Syndrome About Pulmonary Carcinoma

ObjectiveIt' s to investigate the relationship between the radionuclide bone imaging appearance and Traditional Chinese Medicine (TCM) differentiation syndromes of the patients who is diagnosed by pulmonary carcinoma with osseous metastasis, through analyzing characteristics of bone imaging of the different syndrome of TCM patients of pulmonary carcinoma with osseous metastasis. At the same time, we also hope to provide the convenient, suitable and approvable objective target for the Chinese clinical medicine.MethodsWe had retrospectively reviewed the radionuclide bone imaging and clinical records of standard 206 examples (all patients have the pathologic diagnosis, male 137 examples, female 69 examples).The patients involved in the clinical study were divided into the group of Qixueyuzhi, Tanshiyunfei, Yinduxure, Qiyinliangxu. During the study, we had studied the information of the osseous metastasis , such as number,location. Then we established data base, and made statistics analysis by the statistical software SPSS 13.0.Results206 cases were admitted. 97 cases have osseous metastasis , the incidence was 47. 1%. Among the osseous metastasis cases, adenocarcinoma was most common, the incidence was 46. 4%, squamous carcinoma was 28.9%, Undifferentiated carcinoma was 14.4% , small cell lung cancer was 10.3%. The osseous metastasis of pulmonary carcinoma lied in thorax bone(especially is cervical rib) were more common, accounting for about 34. 4% , Secondly vertebrae (28.8%), thirdly pelvis(15. 3%), fourthly acral bone(14.1%)and lastly parietal bone (7.4%) .Multiple abnormal radionuclide concentration was seen in 49.5% patients. 34.0% with some(2-5) foci and 16.5% with only one site.There were 97 cases have osseous metastasis, the incidence was 47.1%, the patient have the osseous metastasis or not was different prominently(P<0. 05),if the patient have osseous metastasis, And the sign of if have osseous metastasis in Yinduxure,Qiyinliangxu syndrome was more common than the other TCM differentiation syndromes, and if not, the other two syndrome was more common. Among all the different pathological types, adenocarcinoma was most common, the incidence was 46. 4%, but the TCM syndrome with different pathological type was not different prominently (P>0. 05) . Regarding to the location of osseous metastasis of pulmonary carcinoma in all the TCM syndrome groups, we also find prominent difference (P<0. 05) , the sign of osseous metastasis in Tanshiyunfei syndrome was the most common. Moreover, the multiple osseous metastasis belong to the group of Qiyinliangxu were more than the other groups of TCM differentiation, and the difference was prominent (P<0. 05).Compared to the other imaging examination, such as X ray,CT, radionuclide bone scan is a more sensitive method for the diagnosis of osseous metastasis. Conclusions1. There lies certain relationship between TCM differentiation syndromes and if or not have osseous metastasis of pulmonary carcinoma, We can take the spot of have osseous metastasis as the referential objective target of Yinduxure syndrome and Qinyiliangxu syndrome, We also can take the spot of don' t have osseous metastasis as the referential objective target of Qixueyuzhi syndrome and Tanshiyunfei syndrome.2. We haven' t find obvious relationship between TCM differentiation syndromes and different pathological types of pulmonary carcinoma.3. There lies certain relationship between TCM differentiation syndromes and location of osseous metastasis, We can take the spot of thoraxbone(especially is cervical rib)as the referential objective target of Tanshiyunfei syndrome, vertebrae as Qixueyuzhi TCM syndrome , pelvis as Yinduxure TCM syndrome, acral bone and parietal bone as Qiyinliangxu TCM syndrome.4. There lies certain relationship between TCM differentiation syndromes and the number of osseous metastasis of pulmonary carcinoma , We can take this sign as the referential objective target of as Qinyinliangxu syndrome. 5. Radionuclide bone scan may provide helpful supplement to the study on relationship between the image appearance and the differentiation of TCM syndrome in osseous metastasis of pulmonary carcinoma.6. Radionuclide bone scan is sensitive for the diagnosis of osseous metastasis, so all the patients with pulmonary carcinoma should be performed radionuclide bone scan, but its specificness is not so good, we must refer to case history and other imaging examination if it is necessary.