学术论文

      骨显像、前列腺特异性抗原及碱性磷酸酶联合应用在前列腺癌患者骨转移诊治中的临床价值

      Combined application of bone imaging and t -PSA,f -PSA,ALP in the diagnosis and treatment of bone me-tastases in patients with prostate cancer

      摘要:
      目的:探讨联合应用骨显像及总前列腺特异性抗原(t-PSA)、游离前列腺特异性抗原(f-PSA)及碱性磷酸酶(ALP)在前列腺癌骨转移诊治中的临床应用价值。方法回顾性分析372例确诊为前列腺癌患者的全身骨显像及血清 t-PSA、f-PSA、ALP 浓度水平的检测结果。结果372例前列腺癌患者中282例被确诊为骨转移;前列腺癌患者中骨转移组的 t-PSA、f-PSA 及 ALP 均明显高于非骨转移组。前列腺癌组与前列腺增生组差异也有统计学意义。骨显像诊断骨转移的灵敏度为91.84%、特异性为76.67%、准确性为88.17%、阳性预测值为92.50%、阴性预测值为75.00%,联合应用全身骨显像及血清 t-PSA、f-PSA、ALP 检测诊断前列腺癌骨转移的灵敏度为95.71%、特异性为87.69%、准确性为94.36%、阳性预测值为87.56%、阴性预测值为92.22%。结论联合应用全身骨显像及血清 t-PSA、f-PSA、ALP 检测诊断前列腺癌骨转移的灵敏度及准确性高,可为前列腺癌骨转移早期诊断、治疗方案的选择、预后判断提供可靠依据。
      Abstract:
      Objective To explore the clinical value of combined application of bone imaging and prostate specific antigen(t -PSA),free prostate specific antigen(f -PSA)and alkaline phosphatase(ALP)in the diagnosis and treatment of prostate cancer bone metastasis.Methods The data of 372 patients diagnosed of prostate cancer were reviewed,and the results of the whole body bone scan and t -PSA,f -PSA,ALP were analyzed retrospectively.&nbsp;Results 282 cases in 372 cases of prostate cancer were diagnosed as bone metastasis.The t -PSA,f -PSA and ALP of prostate cancer patients with metastasis were significantly higher than those of prostate cancer patients without metastasis,the difference was statistically significant (P <0.05).The sensitivity of bone imaging in the diagnosis of bone metastases was 91.84%,the specificity was 76.67%,the accuracy was 88.17%,the positive predictive value was 92.50%,the negative predictive value was 75.00%.The combined application of bone scan and serum t -PSA, f -PSA,ALP detection,the sensitivity of the diagnosis of bone metastasis of prostate cancer was 95.71%,specificity was 87.69%,accuracy was 94.36%,the positive predictive value was 87.56%,the negative predictive value was 92.22%.Conclusion Combined application of whole body bone scan and serum t -PSA,f -PSA,ALP detection has high sensitivity and accuracy in diagnosis of bone metastasis of prostate cancer,and it can provide reliable basis for early diagnosis,treatment and prognosis of prostate cancer.
      Author: Abudureheman Maimaiti Aina Jureti Azhati
      作者单位: 新疆维吾尔自治区人民医院核医学科, 新疆维吾尔自治区乌鲁木齐,830001
      刊 名: 中国基层医药 ISTIC
      年,卷(期): 2017, 24(6)
      在线出版日期: 2017年3月29日