Application Value Analysis Of ^99mTc-MDP Emission Computed Tomography In Bone Metastasis From Non-samll Cell Lung Cancer

Objective: Lung cancer is the most common malignant tumor in China.The bone metastasis is one of the main blood metastasis sites of non-small cell lung cancer,which brings pain to patients and seriously reduces the quality of life and life cycle of patients.Early screening,early diagnosis and early treatment of bone metastasis can effectively improve the quality of life of patients.Because of the invasive and false negative rate of biopsy,bone biopsy is rarely used in clinical diagnosis.Effective imaging data is particularly important in the diagnosis of bone metastasis of lung cancer.The study aims to explore the value of ^99mTc-MDP emission computed tomography in screening bone metastasis from non-small cell lung cancer.Methods:We retrocpectively collected clinical data from 1087 patients with non-small cell lung cancer confirmed by pathology who underwent ^99mTc-MDP emission computed tomography in Fujian Medical University Union Hospital from January 2017 to December 2018,and valued sensitivity,specificity,accuracy and diagnostic efficiency of 9m Tc-MDP emission computed tomography in bone metastases from lung cancer.Results: 52 of 1807 patients were diagnosed as bone metastasis from lung cancer.99 mTc MDP radionuclide bone scan has low sensitivity for bone metastasis of lung cancer.The accuracy and area under ROC curve（AUC）of ^99mTc-MDP emission computed tomography were 92.56% and 0.739,and which proved limited diagnostic valule.By analyzing the characteristics of patients with bone metastases,we found that more than half of the patients with bone metastasis showed multi regional bone metastasis,the components of lung primary tumor from bone metastasis were all pure solid tumors,and bone metastasis of lung cancer was correlated with the maximum diameter grade of primary tumor,the risk of bone metastases from non-small cell lung cancer rise with the increase of size of the primary tumor.Analysis of risk factors for bone metastasis in patients with pure solid primary lung tumor on CT indicates that patients with bone pain,tumor diameter of 3cm-5cm are more likely to occur bone metastasis.Conclusion: ^99mTc-MDP emission computed tomography has high specificity and low sensitivity for the screening of bone metastasis of non-small cell lung cancer,which has limited diagnostic efficiency.^99mTc-MDP emission computed tomography is recommended for non-small cell lung cancer patients with pure solid tumor components of lung primary tumor.Whether bone metastasis screening is needed for non pure solid tumor still needs to be more explored.Patients with ECT negative results should be more alert to bone metastasis if they have symptoms of bone pain,alkaline phosphatase,positive resultsof CEA 、 CA125 、 CA199,and a subgroup with a maximum diameter of 3 cm-5cm.Because the positive predictive value of ECT is low,for ECT positive results,we suggest further PET/CT、MRI and other examinations to confirm the diagnosis of bone metastasis,in order to timely detection and early diagnosis of lung cancer bone metastasis.