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前列腺癌是威胁男性健康的常见肿瘤之一,占2008年全球新发病例的14%(903 500例),位列男性肿瘤的第2位[1]。而在美国,2014年前列腺癌预期新发病例约23.3万,占男性所有新发恶性肿瘤的27%,发病率居首位[2]。与世界部分国家和地区前列腺癌发病率比较,我国前列腺癌处于较低水平,但发病率呈逐年上升的趋势,一项上海地区前列腺癌的研究表明,2009年发病率较2000年提高了3.28~5.33倍,前列腺癌将成为影响我国居民健康的主要恶性肿瘤之一[3]。有大量文献[4-5]说明,相对其他组织和器官来说,前列腺癌细胞对骨髓组织的亲和力更强,通常引起成骨细胞的损伤和增生活跃,在早期往往没有明显临床症状。因此,前列腺癌患者骨转移的早期诊断对前列腺癌的分期、治疗及预后判断具有重要意义。目前对于前列腺癌骨转移的早期诊断,首选具有较高灵敏性的放射性核素骨显像,但缺点是特异性较差,容易产生假阳性,而骨SPECT/CT显像增加了CT扫描并融合图像,除提高了准确的解剖定位外,骨转移的检出率也大大提高。其他的影像学检查手段包括X线平片、CT、MRI及PET/CT等。本文将对前列腺癌骨转移的影像学诊断方法的优缺点进行分析、比较,为临床前列腺癌骨转移的早期诊断提供影像学依据。
前列腺癌骨转移影像诊断方法研究进展
Progress of imaging in the diagnosis of bone metastases of prostate cancer
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摘要: 前列腺癌具有很高的骨转移倾向,在初次诊断时即有较高的骨转移率,所以前列腺癌患者早期筛查骨转移对前列腺癌的分期、治疗及预后判断具有重要意义。放射性核素骨显像是临床常用的骨转移影像学检查方法,对骨转移瘤早期即有较高的检出率,辅以X线平片、CT、MRI等手段,有助于进一步提高诊断的准确性。笔者就前列腺癌骨转移的影像学检查的研究现状做一综述,为临床早期诊断骨转移瘤提供影像学依据。
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关键词:
- 前列腺肿瘤 /
- 肿瘤转移 /
- 放射摄影术 /
- 磁共振成像 /
- 体层摄影术, X线计算机 /
- 正电子发射断层显像术
Abstract: Prostate cancer has a high bone metastasis tendency. At the time of initial diagnosis, there is a high rate of bone metastasis. Early detection of bone metastases in patients with prostate cancer has important significance for staging, treatment and prognosis of prostate cancer. Radionuclide bone imaging(SPECT) is a commonly used imaging examination method of bone metastases, which had a higher detection rate in early bone metastases. Combined with X-ray, CT, MRI and other ways can improve the accuracy of bone metastases. This review summarizes the research status of the imaging examination of bone metastasis of prostate cancer, which provides the imaging evidence for early diagnosis of bone metastases. -
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