The Role of Whole-Body Bone Scanning and Clinical Factors in Detecting Bone Metastases in Patients With Non-small Cell Lung Cancer
| Autor: | Işıl Uzel, Mustafa Yaman, Kamil Kaynak, Serdar Erturan, Günay Aydin, Benan Musellim |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Statistics as Topic Pain Bone Neoplasms Critical Care and Intensive Care Medicine Whole-Body Counting Bone and Bones Metastasis Predictive Value of Tests Carcinoma Non-Small-Cell Lung medicine Carcinoma Humans Radionuclide Imaging Lung cancer Aged Neoplasm Staging Retrospective Studies business.industry Large cell Biopsy Needle Bone metastasis Middle Aged Alkaline Phosphatase medicine.disease Magnetic Resonance Imaging Elevated alkaline phosphatase Predictive value of tests Hypercalcemia Adenocarcinoma Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 127:449-454 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.127.2.449 |
| Popis: | Study objectives Correct detection of bone metastases in patients with non-small cell lung cancer (NSCLC) is crucial for prognosis and selection of an appropriate treatment regimen. The aim of this study was to investigate the role of whole-body bone scanning (WBBS) and clinical factors in detecting bone metastases in NSCLC. Design and patients One hundred twenty-five patients with a diagnosis made between 1998 and 2002 were recruited (squamous cell carcinoma, 54.4%; adenocarcinoma, 32.8%; non-small cell carcinoma, 8.8%; large cell carcinoma, 4%). Clinical factors suggesting bone metastasis (skeletal pain, elevated alkaline phosphatase, hypercalcemia) were evaluated. WBBS was performed in all patients, and additional MRI was ordered in 10 patients because of discordance between clinical factors and WBBS findings. Measurements and results Bone metastases were detected in 53% (n = 21) of 39 clinical factor-positive patients, 5.8% (n = 5) of 86 clinical factor-negative patients, and 20.8% of total patients. The existence of bone-specific clinical factors as indicators of metastasis presented 53.8% positive predictive value (PPV), 94.2% negative predictive value (NPV), and 81.6% accuracy. However, the findings of WBBS showed 73.5% PPV, 97.8% NPV, and 91.2% accuracy. Adenocarcinoma was the most common cell type found in patients with bone metastasis (39%). The routine bone scanning prevented two futile thoracotomies (8%) in 25 patients with apparently operable lung cancer. Conclusions In spite of the high NPV of the bone-specific clinical factors and the high value obtained in the false-positive findings in the bone scan, the present study indicates that in patients for whom surgical therapy is an option, preoperative staging using WBBS can be helpful to avoid misstaging due to asymptomatic bone metastases. |
| Databáze: | OpenAIRE |
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