放射性核素骨显像联合血清学指标在前列腺癌骨转移中的诊疗价值

目的：探讨放射性核素骨显像联合血清学指标检测在前列腺癌骨转移中的诊疗价值。方法：将72例前列腺癌患者分为肿瘤骨转移组和无骨肿瘤转移组，同时选取前列腺良性病变患者32例和参加体检30例健康人作为对照，检测各组外周血前列腺抗原（PSA）和游离前列腺抗原（fPSA），并检测骨转移患者的骨特异性碱性磷酸酶（BAP）、碱性磷酸酶（ALP）水平。结果：与健康人相比，无骨转移组前列腺癌患者的PSA和fPSA水平明显提高（P=0．044和P=0．041），有骨转移组前列腺癌患者的PSA和fPSA升高更明显（P〈0．01）；患者骨转移灶数目≤2与〉2时PSA和fPSA相比差异有统计学意义（P均〈0．01）；随着骨转移分级的增高，前列腺癌骨转移患者血清PSA、ALP和BAP的水平也逐步升高，呈高度的正相关（r=0．982，P=0．005；r=0．957，P=0．042；r=0．963，P=0．034）；骨转移患者PSA〈30ug／L与PSA≥30〉g／L例数相比差异有统计学意义（P〈0．01）；骨转移患者BAP〈20〉g／L与BAP≥20μg／L患者例数相比差异有统计学意义（P〈0．01）；BAP的假阳性率仅为21．62％，明显低于ALP的72．97％（P〈0．01）。结论：放射性核素骨显像仍是诊断前列腺癌骨转移的首要方法，血清学PSA、fPSA、BAP和ALP也是诊断骨转移的重要方法，当患者PSA水平大于30．0μg／L时，应建议患者行全身放射性核素骨显像检查。

Application of radionuclide bone scintigraphy and serum indexes in diagnosis of bone metas- tasis in prostate cancer patients

Objective： To investigate the application of radionuclide bone scintigraphy and serum indexes in diagnosis of bone metastasis in prostate cancer patients. Methods.. A total of 72 prostate cancer patients were divided into bone metastases group and bone tumor metastasis tumor group, at the same time 32 patients with benign prostate lesion and 30 healthy people were selected as control group. Serum fPSA, PSA, BAP and ALP were measured. Results： Compared with normal healthy people, PSA and fP- SA levels of patients with prostate cancer bone metastases were increased significantly （P=0. 044 and P= 0. 041） and significantly higher PSA and fPSA were observed in patients with prostate cancer bone metastases （P〈0.01 and P〈0.01）. Differences in PSA and fPSA were significant between patients with num- ber of bone metastases ; 2 and patients with number 42 （P〈0.01 and P〈0.01）. The serum levels of PSA,ALP and BAP were increased gradually as increasing bone metastatic grading from M0 to M3, and they were significantly 0. 034）. BAP false posi （P〈 O. 01）. Conclusio sis in prostate cancer p ers. Patients with the 1 scintigraphy. positively correlated （r,=0. 982,P=0. 005;r, =-0. 957,P=0. 042;r, =0. 963,P= tive rate was only 21.62%, which was significantly lower than the 72.97% of ALP n： Radionuclide bone scintigraphy is the main method for diagnosis of bone metasta- atients currently. PSA, ALP and BAP are also important auxiliary diagnostic mark- evel of PSA〉30. 0 ng/mL should take a routine whole-body examination of bone