血清PSA和BALP测定在前列腺癌骨显像诊断中的应用

目的：探讨血PSA和BALP的测定在前列腺癌骨显像诊断中的应用。方法：对96例前列腺癌患者的核素骨显像结果、血清PSA和BALP结果进行回顾性研究。结果：①血清PSA和BALP的值随着骨转移分期的增高而逐步升高,且差异显著（P〈0.01）;②血清PSA和BALP与骨转移的数目呈正相关,相关系数（r）分别为0.582（P〈0.01）和0.768（P〈0.01）;③血清PSA〉20ng/ml时,骨转移的阳性率为65.4%,血清PSA〈20ng/ml时,骨转移的阴性预测值为92.6%;血清BALP〉20u/L时,骨转移的阳性率为58.9%时,骨转移的阴性预测值为76.5%;当血清PSA〈20ng/ml同时BALP〈20u/L时,骨转移的阴性预测值为100%。结论：血清PSA和BALP测定在前列腺癌骨显像诊断中具有重要的应用价值。

The Application of Serum PSA and BALP Measurements in Bone Scanning for Metastasis in Patients with Prostate Cancer Diagnostic

Objective To evaluate the diagnosis value of serum PSA and BALP measurements for scanning bone metastatic inages in patients with prostatic cancer. Methods Retrospective stady on the bone scan images and serum PSA （with CLIA） and bone alkaline pbosphatase （BALP, with ELISA） levels were performed in 96 patients with confirmed prostatic cancer. Results （1） The serum levels of PSA and BALP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings （ P 〈 0.01 ）. （2） The levels of PSA and BALP were significantly positively correlated with the number of bone metastastie lesions （ r = 0. 582, 0. 768, P 〈 0.01 ） （3） With serum PSA 〉 20ng/ml, the positive rate of bone metastasis was 65.4% , with PSA 〈 20ng/ml, the negative predictive value of bone metastasis was 92.6% , with BALP 〉 20u/L, the positive rate of bone metastasis was 58.9%, with BALP 〈 20u/L, the negative predictive value of bone metastasis was 76.5%. However with both PSA 〈 20ng/ml and BALP 〈 20u/L, the negative predictive value of bone metastasis was 100%. Conclusion The combined measurement of the serum PSA and BALP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.