PSA、ECT骨显像诊断前列腺癌骨转移的临床价值

The Clinical Value of PSA and ECT in Diagnosis of Prostate Cancer 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)骨显像诊断前列腺癌骨转移的临床价值。方法 :对 6 7例 (骨转移组 4 4例 ,非骨转移组 2 3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 :ECT骨显像诊断前列腺癌骨转移的敏感性 91.6 7% ,骨显像表现为单个核素浓聚灶的病人 6例 ,仅 2例为前列腺癌骨转移。骨转移组与非骨转移组的PSA值差异有显著性 (87.2 8μg/Lvs 2 5 .37μg/L ,P <0 .0 1) ;PSA与骨转移的程度正相关 ,PSA <10 μg/L ,骨转移率为 0 ;PSA 10～ 2 0 μg/L ,骨转移率 7.6 9% ;PSA 2 0～ 6 0 μg/L ,骨转移率5 3.33% ;PSA 6 0～ 10 0 μg/L ,骨转移率 91.6 7% ;PSA >10 0 μg/L ,骨转移率 10 0 %。 结论 :ECT骨显像对前列腺癌骨转移有较高的敏感性 ,但对单个转移灶诊断的特异性不高。对未经治疗的前列腺癌病人 ,PSA <10 μg/L ,前列腺癌骨转移的可能性极小 ;PSA >10 0 μg/L者 。

Objectives: To evaluate the clinical significance of PSA and ECT bone scans in the diagnosis of bone metastasis in prostate cancer patients. Methods: Sixty seven cases of prostate cancer were reviewed, bone metastasis (BM) occurred in 44 cases, and 23 cases without BM (NBM). The relation between PSA, ECT and bone metastasis was analyzed. Results: The sensitivity of BM with bone scan of ECT was 91.67%. Single local density of radionuclide with bone scan was found in 6 cases , only 2 cases have BM. The value of PSA between BM and Non BM group had significant difference (87.28 μg/L vs 25.37 μg/L, P <0.01). PSA and the degree of bone metastasis was positively correlated. PSA<10 μg/L, the morbidity of BM was 0; PSA 10～20 μg/L, 7.69%; PSA 20～60 μg/L, 53.33%; PSA 60～100 μg/L, 91.67%;and PSA>100 μg/L, 100%. Conclusions: ECT is a high sensitive method in diagnosis of bone metastasis of prostate cancer, but it is not specific in patients with single focus of BM. As for those patients of prostate cancer without any treatment, while PSA<10 μg/L, the morbidity of BM is rare; while PSA>100 μg/L, BM is in high suspect.