摘要
目的:评价前列腺癌患者放射性核素骨显像与血清前列腺特异抗原测定的诊断价值。方法:随机选择前列腺癌患者骨显像示骨转移与骨显像正常患者各35例,前列腺良性病患者30例及健康体检者35例,分别测定其血清中PSA、fPSA、fPSA/tPSA的含量。结果:前列腺癌无骨转移组PSA、fPSA水平较对照组略有升高,但皆无显著性差异(P均>0.05);有骨转移组PSA、fPSA水平则升高均非常显著(P均<0.01);前列腺良性病组PSA、fPSA水平与对照组比较均无显著差异(P均>0.05);同时>2个骨转移灶组PSA、fPSA水平较≤2个骨转移灶的患者PSA、fPSA水平升高均非常显著(P均<0.01)。在骨转移诊断的敏感性和特异性的比较中,fPSA/tPSA比值<0.2诊断的敏感度最高,可达到85.7%,但是其特异度只有45.71%;而放射性核素骨显像(≤2个骨转移灶)+fPSA/tPSA敏感度最低为62.9%,但是可提高特异度达到77.14%。结论:血清PSA、fPSA、fPSA/tPSA水平与骨转移灶发生有一定关系,两者联检可以提高前列腺癌发生骨转移中的诊断特异度,可尽早、全面地发现前列腺癌患者全身骨转移,特别是全身骨显像结果模棱两可时意义更大,有助于前列腺癌骨转移灶的动态监测。
Objective To assess the value of radionuclide bone scan combined with PSA,fPSA and fPSA/tPSA for diagnosis prostatic cancer with bone metastasis.Methods Serum levels of PSA,fPSA and fPSA/tPSA ratio were detemined in ① 35 prostatic cancer patients with definite bone metastasis lesions shown on radionuclide bone scan,② 35 prostatic cancer patients without bone metastasis,③ 30 patients with benign prostatic disorders and ④ 35 controls.Results The serum tumor markers levels in patients with osseous metastasis were significantly higher than those in the other three groups（P0.01）.Among them,the levels in patients with more then 2 bone lesions were significantly higher than those in patients with only one or two bone lesions（P0.01）.The serum tumor markers levels in patients without osseous metastasis were only significantly higher than those in patients with benign prostatic disorders and controls.The sensitivity of fPSA/tPSA ratio0.2 was highest（85.7%）,but specificity lower（45.71%）.The sensitivity combining fPSA/tPSA ratio and radionuclide bone scan（≤2） was lowest（62.9%）,but specificity was highest（77.14%）.Conclusion PSA,fPSA and fPSA/tPSA ratio were related with osseous metastasis from prostatic cancer.Combining them was increase on diagnosis the osseous metastasis of prostatic cancer and is a valuable scheme for early detection of skeletal metastasis of prostatic cancer,especially when the results of bone scanning is equivocal.Detemination of the serum tumor markers levels would be helpful for dynamic monitoring of the extent of metastasis.
出处
《放射免疫学杂志》
CAS
2011年第2期176-178,共3页
Journal of Radioimmanology
