99mTc-MDP SPECT/CT显像联合血清PSA、MMP9对前列腺癌骨转移患者的诊断价值  

Diagnostic value of 99mTc-MDP SPECT/CT imaging combined with serum PSA and MMP9 in patients with prostatic cancer and bone metastases

作　　者：王庆云[1] 吴凌梅 王庆利[1] 冀栓猛[1] WANG Qing-yun;WU Ling-mei;WANG Qing-li;JI Shuan-meng(Department of CTMRI,Xingtai People's Hospital,Xingtai 054031,Hebei,China;Department of Nuclear medicine,Xingtai People's Hospital,Xingtai 054031,Hebei,China)

机构地区：[1]邢台市人民医院CTMRI检查科,河北邢台054031 [2]邢台市人民医院核医学科,河北邢台054031

出　　处：《川北医学院学报》2019年第6期725-728,共4页Journal of North Sichuan Medical College

基　　金：河北省邢台市科技计划项目(2018ZC075)

摘　　要：目的:探讨99mTc-MDP单光子发射型电子计算机断层扫描(SPECT)/CT显像联合血清前列腺特异性抗原(PSA)、基质金属蛋白酶9(MMP9)对前列腺癌(PC)骨转移患者的诊断价值。方法:92例PC患者,均行99mTc-MDP SPECT/CT显像和血清PSA、MMP9检测。比较PC骨转移者与无骨转移者血清PSA、MMP9水平;采用ROC曲线分析血清PSA、MMP9联合检测诊断PC骨转移的价值;以病理结果为金标准,评估99mTc-MDP SPECT/CT显像及其联合血清PSA、MMP9检测诊断PC骨转移的价值。结果:PC骨转移者血清PSA、MMP9水平高于无骨转移者(P<0.05);ROC曲线分析提示血清PSA、MMP9水平联合检测诊断PC骨转移的曲线下面积为0.963,灵敏度为78.3%,特异度为90.1%,约登指数为0.684;而99mTc-MDP SPECT/CT显像诊断PC骨转移的灵敏度为90.63%,特异度为71.43%,准确度为84.78%;99mTc-MDP SPECT/CT显像联合血清PSA、MMP9诊断PC骨转移的特异度92.86%,准确度93.48%,较单独99mTc-MDP SPECT/CT显像,差异有统计学意义(P<0.05),而灵敏度差异无统计学意义;99mTc-MDP SPECT/CT显像联合血清PSA、MMP9对PC骨转移程度的准确检出率为92.19%。结论:与单独99mTc-MDP SPECT/CT显像比较,其联合血清PSA、MMP9检测可明显提高PC骨转移诊断的特异度和准确度,并可提高对PC患者骨转移程度的准确检出率。Objective:To explore diagnostic value of 99mTc-MDP single photon emission computed tomography(SPECT)/CT imaging combined with serum prostate specific antigen(PSA)and matrix metalloproteinase-9(MMP9)in patients with prostatic cancer(PC)and bone metastases.Methods:92 PC patients were tested for 99mTc-MDP SPECT/CT imaging,serum PSA and MMP9.The levels of serum PSA and MMP9P were compared between patients with PC bone metastases and without bone metastases.ROC curve analysis was applied to analyze diagnostic value of combined detection with serum PSA and MMP9 for PC bone metastasis.Taking pathological results as golden standard,diagnostic value of 99mTc-MDP SPECT/CT imaging combined with serum PSA and MMP9 detection for PC bone metastasis was evaluated.Results:The levels of serum PSA and MMP9 in patients with PC bone metastases were significantly higher than those without PC bone metastasis(P<0.05).ROC curve analysis indicated that the area under the curve(AUC),sensitivity,specificity and Yoden index of combined detection with serum PSA and MMP9 for diagnosis of PC bone metastasis were 0.963,78.3%,90.1%and 0.684,respectively.The sensitivity,specificity and accuracy of 99mTc-MDP SPECT/CT imaging for diagnosis of PC bone metastases were 90.63%,71.43%and 84.78%respectively.The specificity and accuracy of 99mTc-MDP SPECT/CT imaging combined with serum PSA and MMP9(92.86%,93.48%)for diagnosis of PC bone metastasis were significantly higher than those of 99mTc-MDP SPECT/CT imaging,the difference was statistically significant(P<0.05).The accurate detection rate of 99mTc-MDP SPECT/CT imaging combined with serum PSA and MMP9 for PC bone metastasis was 92.19%.Conclusion:Compared with 99mTc-MDP SPECT/CT imaging,99mTc-MDP SPECT/CT imaging combined with serum PSA and MMP9 detection can significantly improve diagnostic specificity and accuracy of PC bone metastasis diagnosis,and can improve accurate detection rate of bone metastasis in PC patients.

关 键 词：前列腺癌 骨转移 血清前列腺特异性抗原 基质金属蛋白酶9 单光子发射型电子计算机断层扫描 

分 类 号：R614[医药卫生—麻醉学]