Abstract:
Objective To explore the diagnostic value and efficiency of using whole body bone scintigraphy (WBS) combined with thelevels of tumor markers to evaluate non-small cell lung cancer (NSCLC) patients with bone metastases.
Methods One-hundred andeighty-five cases of NSCLC, confirmed by pathology or cytological examination from January 2014 to June 2016, were emrolled fromthe Affiliated Tumor Hospital of Guangxi Medical University. WBS and test results of tumor markers, such as serum carcinoembryonicantigen (CEA), serum carbohydrate antigen (CA125), and cytokeratin CK19 (CYFRA21-1), were analyzed. WBS results were assessed bythe Soloway classification criteria and divided into four grades: Correlations between WBS classification and the levels of tumor markers were determined with Spearman correlation analyses.
Results Seventy-eight of the 185 NSCLC patients had bone metastases (arate of 42.16%). The sensitivity and specificity of WBS were 91.02% (71/78) and 85.98% (92/107), respectively. The CEA, CA125, andCYFRA21-1 levels in bone metastases patients were higher than those in NSCLC patients without bone metastases (P < 0.05). In the 78patients with bone metastases, there were seven cases of EOD0 (8.98%), 39 cases of EOD1 (50%), 17 cases of EOD2 (21.8%), and 15cases of EOD3 (19.2%). The correlations between WBS grade and CEA, CA125, and CYFRA21-1 levels were: rs=0.579, 0.274, and 0.327, respectively (P < 0.05). The combined WBS and tumor marker diagnostic performance was significantly better than either alone (AUC=0.922), and their sensitivity and specificity increased (92.3% and 86.0%, respectively).
Conclusions WBS shows high clinical efficacy inthe diagnosis of NSCLC with bone metastases. Furthermore, it can be used as a screening test for bone metastases of NSCLC, whichhas important clinical implications. WBS combined with CEA, CA125, and CYFRA21- 1 examination improves the detection rate ofNSCLC bone metastases, thereby enhancing its clinical utility.