联合检测血清碱性磷酸酶与骨钙素在前列腺癌早期骨转移中的诊断价值

Diagnosis value of serum ALP and osteocalcin in early prostate cancer bone metastasis

目的：探讨血清碱性磷酸酶（ALP）和骨钙素（osteocalcin）联合检测在早期前列腺癌（PCa）骨转移中的诊断价值及意义。方法：2010年6月~2012年12月重庆市长寿区人民医院泌尿外科收治的87例PCa患者经核素骨显像诊断后分为51例骨转移组和36例非骨转移组,对所有患者进行血清ALP和骨钙素检测,分析两组患者ALP和骨钙素的检测结果及灵敏度、特异性、准确度、似然比和预测值,分析二者联合检测的灵敏度和特异性及在不同程度骨转移中表达水平。结果：骨转移组患者ALP和骨钙素水平高于非转移组和正常对照组,非转移组ALP高于正常对照组,骨钙素低于正常对照组,差异具有统计学意义（P〈0.05）。ALP和骨钙素单独检测灵敏度分别为77.2%和70.6%,特异性分别为61.1%和54.6%,二者联合检测的灵敏度和特异性为93.3%和82.33%,显著高于单独检测（P〈0.05）。随着骨转移分级的增加而增加,ALP和骨钙素表达水平逐渐升高,差异具有统计学意义（P〈0.05）。结论：ALP和骨钙素检测能够用于PCa骨转移早期诊断和预警,联合检测可提高其诊断效率。

[ABSTRACT]Objective：To explore the role and significance of the joint detection of serum alkaline phosphatase （ALP） and osteocalcin in prostate cancer bone metastases.Methods：A total of 87 cases of prostate cancer patients were diagnosed by radionuclide bone imaging,and 5 1 cases of them were included in the bone metastases group,while the other 36 cases were se-lected as the non-metastases group.Serum levels of ALP and osteocalcin of all patients were detected.The sensitivity,specifici-ty,accuracy,likelihood ratio and the predictive value of patients in the two groups were analyzed.The sensitivity and specifici-ty of the combined detection of ALP and osteocalcin and their expression levels in different bone metastases degrees were ana-lyzed.Results：Serum ALP and osteocalcin levels of patients in metastases group were higher than those in non-metastases group and normal control group.In non-metastases group,the ALP level was higher than that in normal control group,while its osteocalcin level was lower than that in control group （P 〈0.05）;The sensitivities of ALP and osteocalcin were 77.2% and 70.6%,respectively,and their specificities were 61.1% and 54.6%,respectively.The sensitivity and specificity became 93.3%and 82.33% in combined detection of ALP and osteocalcin,which was significantly higher than the single detection （P 〈0.05）. The expression levels of ALP and osteocalcin increased with the increase of the metastases degrees （P 〈0.05 ）.Conclusions：Combined detection of ALP and osteocalcin can be used in the early diagnosis of prostate cancer with improved diagnostic effi-ciency.