机构地区:[1]鄂东医疗集团黄石市中心医院湖北理工学院附属医院核医学科,湖北黄石435001
出 处:《标记免疫分析与临床》2021年第2期231-234,283,共5页Labeled Immunoassays and Clinical Medicine
摘 要:目的比较血清前列腺特异抗原(total prostate-specific antigen,TPSA)检测与^(99)Tc^(m)-MDP显像(whole body scan,WBS)对前列腺癌骨转移的诊断价值。方法前列腺癌的临床分期采用AU标准,分为A、B、C、D期。采用双探头SPECT,低能准直器对前列腺癌患者进行全身骨显像;采用电化学发光法同期检测前列腺癌患者治疗前血清TPSA。统计学方法采用卡方检验。结果前列腺癌患者D期WBS的灵敏度与A、B、C期合并比较差异具有统计学意义(χ^(2)=39.460,P<0.01);前列腺癌患者D期TPSA的灵敏度与A、B、C合并期比较差异具有统计学意义(χ^(2)=4.020,P<0.05)。前列腺癌患者D期联合检查的灵敏度与A、B、C合并期比较差异具有统计学意义(χ^(2)=4.570,P<0.05)。前列腺癌患者D期的WBS、TPSA和联合检查中WBS与TPSA的灵敏度比较差异具有统计学意义(χ^(2)=3.980,P<0.05),而WBS与联合检查的灵敏度比较差异无统计学意义(χ^(2)=0.934,P>0.05)。在40例前列腺癌骨转移的WBS阳性患者中,TPSA>100 ng/mL占50.0%与TPSA 30~100 ng/mL占45.0%,两者比较差异无统计学意义(χ^(2)=0.359,P>0.05);TPSA 30~100 ng/mL占45.0%与TPSA<30 ng/mL占5.0%,两者比较差异具有统计学意义(χ^(2)=12.610,P<0.01)。在80例前列腺癌患者中,TPSA>100 ng/mL患者,WBS阳性占95.2%;30~100ng/mL患者,WBS阳性占78.3%;<30 ng/mL患者,WBS阳性占5.6%。结论WBS对于前列腺癌骨转移早期诊断,A、B、C与D(非骨转移与骨转移)分期具有重要作用,如肿瘤未突破包膜(A、B期)则发生淋巴结转移、骨转移的概率不高,如肿瘤突破包膜(C期)则骨转移的概率较高,结合TPSA检查,当TPSA≥30 ng/mL时,是最佳进行WBS诊断骨转移的时期,当TPSA<30 ng/mL时,可暂时不行WBS,以减轻患者的经济、生理负担。Objective The diagnostic value of serum prostate specific antigen(TPSA)and ^(99)Tc^(m)-MDP imaging(WBS)for prostate cancer bone metastasis was compared.Methods The clinical stage of prostate cancer was divided into A,B,C,and D stages using the AU standard.Whole-body bone imaging was performed on patients with prostate cancer using dual-probe SPECT,low-energy collimator.Pre-treatment serum TPSA was detected by electrochemiluminescence in patients with prostate cancer.Statistical analyses were performed with chi-square test and zero-response test.Results The sensitivity of stage D WBS in patients with prostate cancer was significantly different from the combined phases of A,B,and C(χ^(2)=39.460,P<0.01).The sensitivity of stage D TPSA in patients with prostate cancer was different from the combined phases of A,B,and C with a significant difference(χ^(2)=4.020,P<0.05).There was a statistically significant difference in the sensitivity of the combined examination of stage D in patients with prostate cancer and the combined stages of A,B and C(χ^(2)=4.570,P<0.05).There was a statistically significant difference in the sensitivity of WBS,TPSA and combined examination between WBS and TPSA in patients with prostate cancer(χ^(2)=3.980,P<0.05),while the sensitivity of WBS and combined examination had no significant difference(χ^(2)=0.934,P>0.05).Among the 40 WBS-positive patients with prostate cancer bone metastases,TPSA>100ng/mL accounted for 50.0%and TPSA 30-100ng/mL accounted for 45.0%.There was no significant difference between the two(χ^(2)=0.359,P>0.05).TPSA 30-100ng/mL accounted for 45.0%and TPSA<30ng/mL accounted for 5.0%,and the difference between the two was statistically significant(χ^(2)=12.610,P<0.01).Among 80 prostate cancer patients,95.2%of patients with TPSA>100ng/mL were WBS positive and patients with 30-100ng/mL,WBS positive accounted for 78.3%,while patients<30ng/mL,WBS positive accounted for 5.6%.Conclusion WBS for the early diagnosis of bone metastases of prostate cancer,A,B,C and D(bone metastas
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