Application Value Of SPECT Bone Scintigraphy Combined With Tumor Makers In NSCLC With Bone Metastases

Objective To explore the diagnostic value and efficiency evaluation of combined SPECT bone scintigraphy combined with tumor makers level in non-small cell lung cancer(NSCLC)patients with bone metastases.Methods 185 cases confirmed by pathology of non-small cell lung cancer patients from January 2014 to June 2016 were involved in this retrospective analysis.The reasults of SPECT bone scintigraphy and tumor makers,such as serum carcinoembryonic antigen(CEA),serum carbohydrate antigen(CA125),cytokeratin(CK19)(CYFRA21-1)test results were analyzed.The SPECT bone scintigraphy result of NSCLC patients were classified by Soloway classification criterion,which were divided into 4 grades,EOD0 : haven't seen any abnormalities in the SPECT bone scintigraphy;EOD1:1-2 bone metastases;EOD2: 3-5 bone metastases;EOD3: more than 5 bone metastases.The correlations between the SPECT bone scintigraphy classification and the CEA,CA125?CYFRA21-1 level were analyzed with Spearman correlation analysis.Results 78 patients were found in 185 cases of patients with NSCLC with bone metastases and the bone metastasis rate was 42.16%(78/187).The sensitivity and specificity of SPECT bone scintigraphy were 91.02%(71/78)and 85.98%(92/107),respectively.The CEA ?CA125?CYFRA21-1 level in the bone metastases patients than those in the group of NSCLC without bonemetastases(P<0.05).In 78 patients with bone metastases,a total of 7 cases of EOD0,accounted for 8.98%(7/78),EOD1,a total of 39 patients,50%(39/78),EOD2,a total of 17 patients,21.79%(17/78),EOD3,a total of 15 cases,19.23%(15/78).The correlation between SPECT imaging grade and CEA,CA125,CYFRA21-1 levels is evaluated by Spearman's rank correlation(rs=0.579?0.274?0.327,P<0.05).SPECT bone scintigraphy and tumor makers' s diagnostic performance were singificantly higher than each of them single test(AUC=0.922),and their sensitivity and specificity became higher(97.44% and 86.00%,respectively).Conclusion The SPECT bone scintigraphy shows high clinical diagnostic performance in the diagnosis of NSCLC with bone metastases,and it can be used as screening diagnosis of bone metastases of NSCLC,which has important clinical application.SPECT bone scintigraphy combined with CEA?CA125 and CYFRA21-1 detection help to improve NSCLC bone metastases detection rate,clinical practicability.