Clinical Research Of Vertebral Metastasis In Lung Cancer

ObjectiveTo explore the clinical characteristics of vertebral metastasis in lung cancer cases and determine the advantages and disadvantages of different imageology methods in diagnosis efficiency of vertebra osseous metastasis patients.Methods230 cases of vertebral metastasis in lung cancer were collected and retrospective studies were carried out according to clinical data.Among then,76 and 15 lung cancer cases of vertebral metastasis were masculine appearance with ECT and PET checking method respectively.We compared the diagnosis sensitivity of different checking methods such as CT,MRI and PET and described typical examples of lung cancer cases.Results1.Vertebral metastasis in lung cancer patients were almost 50-70 years old,it was highly correlated with the peak age of lung cancer pathogenetic process.2.The average percentages of vertebral metastasis cases in lung cancer patients were lined below one by one:superior lobe of left lung(27.83%),superior lobe of right lung (25.47%),inferior lobe of right lung(21.70%),inferior lobe of left lung(16.04%) and middle lobe of right lung(8.96%).3.The percentages of pathological types of vertebral metastasis cases in lung cancer patients are lined below one by one:adenocarcinoma(60.20%),squamous carcinoma (25.00%),small cell carcinoma(14.29%) and large cell carcinoma(0.51%).The percentage of poorly differentiated cases amout to 72.79%.4.The skeletal related events(SREs) of vertebra metastasis cases occurred frequently, especially ostealgia(87.83%),spinal compression(30.87%) and pathological fracture (12.17%).However,incidence rate of hypercalcinemia is much lower,only accounting for 2.47%.The percentage of pathological fracture in over 50 year old patients obvious increased.5.There are 30 cases were antephase misdiagnosed in totally 230 vertebra metastasis cases,misdiagnosis rate was 13.04%.Among them,8 cases(3.48%) were misdiagnosed as hyperosteogeny and bone degeneration.The longest time of antephase misdiagnosis reach to 18 months and average antephase misdiagnosis period was 4 months.6.Time of vertebra metastasis was diagnosed to death were less than 12 months in 26 death cases.There was significant difference between three different time phases,death cases in 3 months were the most,accounting for 53.85%in total death patients.7.The MRI and CT positive rates with ECT scanning check in 76 vertebra metastasis cases were 93.3%and 42.5%respectively,the efficiency of MRI scanning check was more efficient than CT.8.The sensitivities of ECT,MRI scanning instruments were 100%in 15 vertebra metastasis cases detected by PET scanning.The average numbers of detection focus amount to 3.67/case in PET,2.2/case in ECT,1.5/case in MRI,1/case in CT.Positioning deviation was appeared in 4/6 patients when using MRI,CT and ECT combination checks.Conclusion1.Lung cancer patients were almost 50-70 years old.The most frequent occurring position in primary cancer cases was superior lobe of left lung.The highest percentages of pathological types were adenocarcinoma and poorly differentiated accounted for the most. The highest percentage of SREs occurrence was ostealgia,the second one was spinal compression and pathological fracture,especially the age was over 50.The incidence rate of hypercalcinemia was much lower.2.30 cases were antephase misdiagnosed in totally 230 vertebra metastasis cases, misdiagnosis rate was13.04%.Among them,hyperosteogeny and bone degeneration cases were the most one.The longest and time of antephase misdiagnosis reach to 18 months and average antephase misdiagnosis period was 4 months.3.We analyzed 26 death cases that were vertebra metastasis,the life span was less than 1 year when final diagnosis was determined,it was observed most patients could not survive over 3 months.4.ECT scanning instrument was more sensitive but MRI detection had more specificity.5.Because PET scanning made vertebra metastasis diagnosis much easier,the sensitivity of PET scanning instrument was higher than any other imageology checking methods in vertebra metastasis diagnosis process.But PET scanning instrument should combine CT and MRI to identify complex diagnosis so as to enhance its anatomy positioning ability.