全身骨显像诊断前列腺癌骨转移与PSA水平及病理分级的相关性研究

Study of relationship between the bone imaging, level of PSA and pathology grade in diagnosis of prostate carcinoma bone metastasis

    摘要
  • 摘要:
    目的 探讨核素全身骨显像诊断前列腺癌骨转移与血清前列腺特异性抗原（PSA）水平及前列腺癌病理分级的关系，并研究前列腺癌发生骨转移的规律和特点。
    方法 对107例前列腺癌患者术前用放免法测定其血清PSA水平，并进行99Tcm-亚甲基二膦酸盐全身骨显像，术后对其进行病理分级，分析前列腺癌骨转移与3种方法检查结果的相关性。
    结果 107例前列腺癌患者全身骨显像发现49例发生骨转移，占45.8%（49/107），其中，不同病理分组之间的骨转移发生率差异有统计学意义（χ2＝15.41，P < 0.01），前列腺癌分化程度越低，骨转移发生率越高；随着血清中PSA水平的升高，骨转移的发生率明显增加，PSA > 20μg/L者有骨转移可能，PSA > 60μg/L者骨转移的可能性极大。
    结论 前列腺癌患者骨转移发生率与前列腺癌的分化程度、血清PSA水平有一定的关系。低分化者或PSA > 20μg/L者，骨转移发生率高。对于初诊的前列腺癌患者，PSA < 20μg/L者应密切随访其PSA水平变化；PSA > 20μg/L者应行骨显像以确诊；PSA > 60μg/L者临床可诊断为骨转移。

     

    Abstract:
    Objective To investigate the relationship between the level of serum prostate-specific antigen(PSA), pathology grade and bone imaging in diagnosis of bone metastasis in prostatic carcinoma.
    Methods Serum PSA, whole body bone imaging with99Tcm-methylene diphosphonate, pathology grade in 107 cases of prostatic carcinoma were retrospectively reviewed as to their correlation with bone metastasis.
    Results Fourty-nine of 107 cases demonstrated bone metastasis by whole body bone imaging.There were significant difference in bone metastasis incidence rate among high differentiation group, middle differentiation group and low differentiation group.The results showed that when PSA < 20 μg/L, the possibility of bone metastasis was extremely low and follow-up studies were reuired.When serum PSA > 20 μg/L, bone metastasis should be considered and bone imaging was necessary.
    Conclusions There were some relationship among the level of PSA, pathology grade and bone metastasis.The possibility of bone metastasis became high when PSA > 20 μg/L.If PSA > 60 μg/L, a clinical diagnosis of bone metastasis might be made.

     

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