Diagnostic value of whole body bone scintigraphy combined with tumor markers for bone metastases of non-small cell lung cancer / 中国肿瘤临床

ABSTRACT

Objective: To explore the diagnostic value and efficiency of using whole body bone scintigraphy (WBS) combined with the levels of tumor markers to evaluate non-small cell lung cancer (NSCLC) patients with bone metastases. Methods: One-hundred and eighty-five cases of NSCLC, confirmed by pathology or cytological examination from January 2014 to June 2016, were emrolled from the Affiliated Tumor Hospital of Guangxi Medical University. WBS and test results of tumor markers, such as serum carcinoembryonic antigen (CEA), serum carbohydrate antigen (CA125), and cytokeratin CK19 (CYFRA21-1), were analyzed. WBS results were assessed by the Soloway classification criteria and divided into four grades: Correlations between WBS classification and the levels of tumor mark-ers were determined with Spearman correlation analyses. Results: Seventy-eight of the 185 NSCLC patients had bone metastases (a rate of 42.16%). The sensitivity and specificity of WBS were 91.02%(71/78) and 85.98%(92/107), respectively. The CEA, CA125, and CYFRA21-1 levels in bone metastases patients were higher than those in NSCLC patients without bone metastases (P＜0.05). In the 78 patients with bone metastases, there were seven cases of EOD0 (8.98%), 39 cases of EOD1 (50%), 17 cases of EOD2 (21.8%), and 15 cases 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 in the diagnosis of NSCLC with bone metastases. Furthermore, it can be used as a screening test for bone metastases of NSCLC, which has important clinical implications. WBS combined with CEA, CA125, and CYFRA21-1 examination improves the detection rate of NSCLC bone metastases, thereby enhancing its clinical utility.