探讨初诊前列腺癌骨转移风险的预测指标  

Investigation of Predictors in Newly Diagnosed Prostate Cancer Patients with Bone Metastasis

作　　者：毛金磊[1] 陈宇琼 何薇[1] 

机构地区：[1]上海市复旦大学附属华东医院核医学科,上海200040 [2]中国同辐股份有限公司,北京100045

出　　处：《标记免疫分析与临床》2014年第4期390-393,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的 探讨初诊前列腺癌患者的血清前列腺特异性抗原（prostate-specific antigen,SA）、血清碱性磷酸酶（alkaline phosphatase,ALP）、血清骨特异性碱性磷酸酶（bone-specific alkaline phosphatase,BAP）以及Gleason评分对骨扫描阳性（骨转移）的预测价值.方法 前瞻性地研究212名初次诊断前列腺癌患者的骨扫描结果和其PSA、ALP、BAP以及Gleason评分的关系.结果 单因素方差分析结果表明,血清PSA、ALP、BAP以及病理Gleason能独立得预测骨扫描转移的阳性结果.多因素方差分析结果提示血清PSA＞ 50ng/mL,血清ALP＞ 1000μg/L,血清BAP ＞20.1μg/L以及Gleason病理评分7～10分都是骨扫描阳性骨转移结局的危险因素,即具有预测价值.而PSA＜ 15ng/mL,血清ALP＜ 130μg/L,血清BAP＜ 20μg/L以及Gleason病理评分＜7的患者骨扫描阳性的可能性很低,可以结合临床情况再考虑做骨扫描检查.结论 除了PSA和Gleason评分两个指标外,血清ALP特别是BAP也可以考虑做为衡量初诊前列腺癌患者骨转移风险的预测指标.Objective To explore the clinical value of the serum prostate specific antigen （ PSA）, serum alkaline phosphatase （ALP）, serum bone specific alkaline phosphatase （BAP） and Gleason score in patients with newly diagnosed prostate cancer to predict positive bone metastasis results of radionuclide bone scintigraphy. Methods The serum levels of PSA, ALP, BAP and Gleason scores in 212 patients with newly diagnosed prostate cancer were detected. The relationship between Results of radionuclide bonescintigraphy and its PSA, ALP, BAP and Gleason scores were analyzed. Results The single variance analysis showed that serum PSA, ALP, BAP and Gleason score could independently predict positive bone metastasis in radionuclide bone scintigraphy. Multivariance analysis suggested that serum PSA 〉 50ng/mL, serum ALP 〉 1000μg/L, serum BAP 〉 20. 1 μg/L and Gleason score 7-10 points were risk factors for positive bone metastases outcome in bone scintigraphy, which had predictive value. The low probability was found in patients with PSA 〈 15ng/mL, serum ALP 〈 130μg/L, serum BAP 〈 20μg/L and Gleason score 〈 7, which can be combined with the clinical situation in the consideration of a bone scintigraphy. Conclusion In addition to PSA and Gleason score, serum ALP especially BAP could also be considered as a prediction index to measure the risk of newly diagnosed prostate cancer patients with bone metastasis.

关 键 词：前列腺肿瘤 前列腺特异抗原 血清碱性磷酸酶 血清骨特异性碱性磷酸酶 同位素骨扫描 骨转移 

分 类 号：R737.25[医药卫生—肿瘤]