Kane Christopher J, Amling Christopher L, Johnstone Peter A S, Pak Nali, Lance Raymond S, Thrasher J Brantley, Foley John P, Riffenburgh Robert H, Moul Judd W
Department of Urology, Naval Medical Center San Diego, San Diego, California, USA.
Urology. 2003 Mar;61(3):607-11. doi: 10.1016/s0090-4295(02)02411-1.
To define the utility of bone scan and computed tomography (CT) in the evaluation of patients with biochemical recurrence after radical prostatectomy.
A retrospective analysis of the Center for Prostate Disease Research database was undertaken to identify patients who underwent radical prostatectomy between 1989 and 1998. Patients who developed biochemical recurrence (two prostate-specific antigen [PSA] levels greater than 0.2 ng/mL) and underwent either bone scan or CT within 3 years of this recurrence were selected for analysis. The preoperative clinical parameters, pathologic findings, serum PSA levels, follow-up data, and radiographic results were reviewed.
One hundred thirty-two patients with biochemical recurrence and a bone scan or CT scan were identified. Of the 127 bone scans, 12 (9.4%) were positive. The patients with true-positive bone scans had an average PSA at the time of the bone scan of 61.3 +/- 71.2 ng/mL (range 1.3 to 123). Their PSA velocities, calculated from the PSA levels determined immediately before the radiographic studies, averaged 22.1 +/- 24.7 ng/mL/mo (range 0.14 to 60.0). Only 2 patients with a positive bone scan had a PSA velocity of less than 0.5 ng/mL/mo. Of the 86 CT scans, 12 (14.0%) were positive. On logistic regression analysis, PSA and PSA velocity predicted the bone scan result (P <0.001 each) and PSA velocity predicted the CT scan result (P = 0.047).
Patients with biochemical recurrence after radical prostatectomy have a low probability of a positive bone scan (9.4%) or a positive CT scan (14.0%) within 3 years of biochemical recurrence. Most patients with a positive bone scan have a high PSA level and a high PSA velocity (greater than 0.5 ng/mL/mo).
确定骨扫描和计算机断层扫描（CT）在评估前列腺癌根治术后生化复发患者中的作用。
对前列腺疾病研究中心数据库进行回顾性分析，以确定1989年至1998年间接受前列腺癌根治术的患者。选择在生化复发后3年内出现生化复发（两次前列腺特异性抗原[PSA]水平大于0.2 ng/mL）并接受骨扫描或CT检查的患者进行分析。回顾术前临床参数、病理结果、血清PSA水平、随访数据和影像学结果。
确定了132例生化复发且进行了骨扫描或CT扫描的患者。在127例骨扫描中，12例（9.4%）为阳性。骨扫描真阳性的患者在骨扫描时的平均PSA为61.3±71.2 ng/mL（范围1.3至123）。根据影像学检查前即刻测定的PSA水平计算，他们的PSA速度平均为22.1±24.7 ng/mL/月（范围0.14至60.0）。只有2例骨扫描阳性的患者PSA速度小于0.5 ng/mL/月。在86例CT扫描中，12例（14.0%）为阳性。逻辑回归分析显示，PSA和PSA速度可预测骨扫描结果（P均<0.001），PSA速度可预测CT扫描结果（P = 0.047）。
前列腺癌根治术后生化复发的患者在生化复发后3年内骨扫描阳性（9.4%）或CT扫描阳性（14.0%）的概率较低。大多数骨扫描阳性的患者PSA水平高且PSA速度快（大于0.5 ng/mL/月）。
