PSA、ECT骨显像诊断前列腺癌骨转移的临床意义

Clinical significance of PSA and ECT in diagnosis of prostate cancer with bone metastasis

目的:探讨前列腺特异抗原(PSA)、发射型计算机断层扫描(ECT)99Tc-MDP骨显像诊断前列腺癌骨转移的临床意义。方法:对80例(骨转移组31例,非骨转移组49例)前列腺癌病人的PSA、ECT与骨转移的关系进行回顾性分析。结果:骨转移组与非骨转移组的PSA值差异有显著性(139.36μg/Lvs37.58μg/L,P<0.01);PSA与骨转移的程度正相关,PSA<10μg/L,骨转移率为15.38%;PSA<20μg/L,骨转移率为19.35%;PSA>20μg/L,骨转移率为51.02%;PSA>100μg/L,骨转移率为78.95%。结论:ECT骨显像对前列腺癌骨转移有较高的敏感性,对未经治疗的前列腺癌病人,PSA<10μg/L,前列腺癌骨转移的可能性极小;PSA>100μg/L者,骨转移的可能性极大。PSA>20μg/L,建议行ECT骨扫描。

Objective：To evaluate the clinical significance of PSA and ECT bone scans in the diagnosis of bone metastasis in prostate cancer patients. Methods： Eighty cases of postate cancer were reviewed, bone metastasis （BM） occurred in 31 cases, and 49 cases without BM （NBM）. The relation between PSA, ECT and bone metastasis was analyzed. Results： The value of PSA between BM and NBM groups had significant difference （139.36μg/L vs 37.58μg/L, P〈0.01）. PSA and the degree of bone metastasis was positively correlated. PSA〈10μg/L, the morbidity of BM was 15.38%; PSA〈20μg/L, 19.35%%; PSA 〉20μg/L, 51.02%%; and PSA〉100μg/L, 78.95%. Conclusion： ECT is a high sensitive method in diagnosis for bone metastasis of prostate cancer. As for those patients of protate cancer without any treatment, while PSA〈10μg/L, the morbidity of BM is rare; while PSA〉100μg/L,BM is in high suspect. It should be suggested to make the bone scanning when the PSA 〉20μg/L.