前列腺特异抗原和碱性磷酸酶联合检测在早期诊断前列腺癌骨转移中的应用

目的:探讨前列腺特异抗原(PSA)和碱性磷酸酶(ALP)联合检测在早期诊断前列腺癌骨转移中的作用及意义。方法:经核素骨显像将98例前列腺癌患者分为骨转移组和非骨转移组,所有患者均检测PSA和ALP,对比分析两组患者PSA和ALP检测结果、阳性率及与骨转移关系,分析二者联合检测与单项检测对前列腺癌骨转移的敏感度与特异度,以及核素骨显像异常放射性浓聚灶分布情况。结果:骨转移组血清PSA和ALP水平均高于非骨转移组,相比均有显著性差异(P<0.05);PSA单项检测结果骨转移组与非骨转移组阳性率相比无显著性差异(P>0.05),ALP相比有显著性差异(P<0.05);且PSA和ALP值随着骨转移分级增加而增加,呈正相关;PSA和ALP联合检测与单项检测敏感度相比有显著性差异(P<0.05),特异度有极显著性差异(P<0.01);核素骨显像检查阳性结果58.2%,且异常放射性浓聚灶多位于胸腰椎部位。结论:PSA和ALP联合检测有助于早期诊断前列腺癌骨转移,可提高其诊断率。

Value of the Joint Detection of PSA and ALP in the Early Diagnosis of Prostate Cancer Bone Metastasis

Objective: To investigate the role and significance of the joint detection of prostatic specific antigen(PSA) and alkaline phosphatase(ALP) in the early diagnosis of prostate cancer bone metastasis.Methods: By radionuclide bone imaging,98 cases of prostate cancer were divided into bone metastasis group and non-metastasis group.Serum levels of PSA and the ALP were detected in all patients,and the results were analyzed and compared statistically between the two groups in relation to metastasis status.Radionuclide bone scintigraphy were adopted to find radioactive foci.Results: The serum PSA and ALP levels were higher in bone metastasis group than in non-metastasis group(P<0.05),and both indices were positively correlated with the severity of bone metastasis.ALP positive rate was significantly different between the two groups(P<0.05) while PSA positive rate had no difference(P>0.05).The sensitivity(specificity) of joint detection were significantly different from that of ALP or PSA alone.The radionuclide bone scintigraphy positive rate was 58.2%,and abnormal radioactive dense foci were located in the thoracic and lumbar parts.Conclusion: PAS and ALP joint detection is useful for the early diagnosis of prostate cancer bone metastases,and can improve the diagnostic rate.