412例前列腺癌患者血清前列腺特异抗原游离与总量比值及骨转移的分析

目的分析前列腺癌(Pca)患者血清前列腺特异抗原游离(FPSA)与总(TPSA)比值(F/T)的结果及骨转移的特点。方法对412例Pca患者术前血清TPSA、FPSA含量和F/T比值及99mTC-MDPECT全身骨骼显像分为二组进行分析。结果无骨转移组为25.5%(105/412例);有骨转移组为74.5%(307/412)。307例Pca骨转移组患者,共有2907个转移病灶,97.5%(2834/2907)显示为"热区"病灶,2.5%显示为"冷区"病灶(73/2907)。有Pca骨转移组血清TPSA、FPSA和F/T分别是97.9±59.4μg/L,10.2±8.1μg/L和0.09±0.04;无ca骨转移组29.6%(16/54),分别是24.8±23.0μg/L,4.4±3.4μg/L和0.12±0.05;二组有显著性差异(P0.01)。TPSA与骨转移程度呈负相关(r=-0.487,P0.05)。当PSA10μg/L,骨转移率为2.6%;当PSA 10～20μg/L,为10.5%;PSA 21～50μg/L,为52.6%;PSA 51～100μg/L,为92.7%;PSA100μg/L,为100%。F/T比值与骨转移程度呈负相关(r=-0.641,P0.05)。F/T0.15者,有84%的Pca患者有骨转移;F/T0.10者,100%的患者有骨转移。结论血清F/T比值小于0.15者,必要时行ECT全身骨骼显像。骨转移的好发部位依次是盆骨、椎骨和肋骨。

The Ratio of Free to Total Serum Prostate Specific Antigen in 412 Patients with Prostate Cancer and Analysis of Bone Metastasis

Abstract： Objective To analyze the characteristics of the ratio of serum free prostate specific antigen （ FPSA ） to total prostate specific antigen. （TPSA） and bone metastases in patients with prostate cancer （Pca）. Methods 412 patients with prostate cancer were enrolled in this study. The preoperative serum FPSA and TPSA levels in patients were measured and SPECT imaging with 99mTc-MDP were carried out. The patients were further divided into 2 groups according to whether they were found with bone metastases. Results The result showed that 25.5% of patients （105/412） were found without any bone metastasis, and 74.5% of them （307/412） were with bone metastasis. Among the 307 cases of Pca patients with bone metastases, total 2907 metastatic lesions were found. 97.5% of the metastasis showed a ＂hot zone＂ sign, 2.5% of them showed a ＂cold zone＂ sign. The serum levels of TPSA, YPSA and F/T in patients with bone metastasis were 97.9 -59.4lxg/L, 10.2 _＋ 8. 1 μg./L, 0.09 -＋ 0.04, respectively. The serum levels of TPSA, FPSA and F/T in patients without bone metas- tasis were 24.8 ±23.01μg/L, 4.4 ±3.4μg/L, 0.12 0.05, respectively. There was significantly different in TPSA, ±FPSA and F/T between two groups （ P 〈 0.01 ）. The TPSA in patients was positively correlated with bone metastasis （ r = - 0.487, P 〈 0.05 ）. There was positively correlation between the ratio of F/T and bone metastasis （ r = - 0. 641, P 〈 0.05 ）. Conclusion The prostate patients with F/T 〈 0.15 were highly suspected to have bone metastasis. The SPECT bone scan was recommended in these patients when necessary. The bone metastasis predication sites were pelvis, vertebrae and ribs, most of the type of bone metastases were ossifica- tion.