血清PSA联合ECT骨显像检测对前列腺癌骨转移的诊断价值

Diagnostic Value of Serum PSA Combined ECT Bone Imaging in Bone Metastasis of Prostatic Carcinoma

目的:探讨血清PSA联合ECT骨显像检测对前列腺癌骨转移的诊断价值。方法:收集前列腺癌患者110例,对照最终病理检查结果,回顾性分析前列腺癌患者血清PSA及ECT骨显像检测与骨转移的关系。结果:骨显像阳性患者64例,单个核素浓聚灶11例,经病理确诊为转移灶8例,另3例为良性病变;2个以上病灶53例,病理活检全部确诊为转移癌。46例患者经手术确实后,再行抗雄激素治疗,43例转移灶数目明显减少,转移范围缩小。ECT的敏感性、特异性和准确性分别为95.3%,92.9%,90.9%。PSA<10μg/L无骨转移,PSA>100μg/L的患者全部为骨转移;以PSA>20μg/L为临界值,其诊断的准确性最高,达到91.8%,PSA的敏感性及特异性分别为95.6%,85.7%。结论:骨显像与血清PSA浓度联合检测对于前列腺癌骨转移的临床诊断具有重要价值。

Objective：To investigate the diagnostic value of serum prostate-specific antigen （PSA） combined emission computerized tomography （ECT） bone imaging in osseous metastasis of prostatic carcinoma. Methods： One hundred and ten cases with prostatic carcinoma were collected. Comparing the final pathology result, the relationship between PSA, ECT and osseous metastasis of prostatic carcinoma was analyzed retrospectively. Results： Sixty-four cases were positive of bone imaging. Single local density of radionuclide with bone scan was found in 11 cases, among them 8 cases had bone metastasis and 3 cases were benign lesion. Two or more local density of ra- dionuclide with bone scan was found in 53 cases, final pathology biopsy diagnosis was all metastasis carcinoma. After operation demasculinization and antiandrogen therapy, number and area of metastasis decreased significantly. The sensitivity, specificity and accurate rate were 95. 3%, 92.9%,90.9%0. PSA〈10 μg/L, respectively. The patients with PSA〈10 μg/L did not show bone metastasis, while all the patients with PSA〉100 μg/L showed bone metastasis. If took PSA〉20μg/L as diagnostic mark, the accurate rate was the highest （91.8%）. And sensitivity and specificity were 95.6 % and 85.7 %, respectively. Conclusion： It may be an important diagnostic value to use serum PSA combined ECT bone imaging for detection of bone metastasis of prostatic carcinoma.