The Metastatic Characteristics Of Whole Body Bone Scan And The Multivariate Analysis Of Skeletal Metastases In Patients With Esophageal Carcinoma

Objective To study imaging features of radionuclide bone imaging in patients after esophagectomy; summarized the law of skeletal metastases and the major risk factors; evaluate the value of the radionuclide bone scanning in esophageal cancer treatment and follow-up objectively.Methods A retrospective study was made on the clinical data of 201 esophagectomy cases from the year 2000 to 2007. Documenting the time between clinical symptoms to chemotherapy or surgery, local or systemic symptoms or signs of bone, histopathological type, differentiation, clinical stage, tumor location, adjuvant therapy, whole bone scan time, whole body scan results. X, CT, MRI bone scan results. Analyzed the risk factors influencing bone metastasis using statistical methods.Results Among 201 esophagectomy patients, The rate of bone metastasis is 21.39%(43/201). In a review of the history records of 43 patients, the predilection sites were the spine, ribs, pelvis, chest bones, limbs and skull. The highest false positive rate of rib, spine followed in results. Univariate analysis showed that:Surgical operation time, tumor location, squamous cell differentiation, TNM stage, lymph node metastasis, postoperative adjuvant radiotherapy or chemotherapy are standardized row, the time after surgery and the symptoms of local bone related to bone metastasis. Through COX regression analysis found that:the clinical symptoms of patients to surgery, and squamous cell differentiation, TNM stage, local lymph node metastasis and standard postoperative treatment are the main factors of bone metastasis.Conclusion The study indicates that incidence of esophageal cancer with bone metastasis is 21.39% in this article. Spine is the most common sites of metastasis, followed by ribs, pelvis, chest. Skull and limbs are accumulated less. Whole bone scan is used for diagnosis the bone metastasis of esophageal cancer patients with bone metastasis. Ribs and spine has the highest rate of false positive. This article shows that the clinical symptoms of patients to surgery, squamous cell differentiation, TNM stage, local lymph node metastasis and standard postoperative treatment are are primary risk factors which affect the bone metastasis of esophageal patients. Bone metastases occurred easily Within one year after surgery. Clear these risk factors and the time of high incidence of bone metastasis can help to diagnosis bone metastasis early and correctly. Understand the law of esophageal cancer's bone metastasis and the factors caused false positive results in radionuclide whole body bone scan are favorable for improve the accuracy of nuclear medicine diagnosis bone metastasis.