Shih W J, Mitchell B, Wierzbinski B, Magocum S, Ryo U Y
Nuclear Medicine Service, Veterans Affairs Medical Center, Lexington 40536-0084.
Clin Nucl Med. 1991 Oct;16(10):763-6. doi: 10.1097/00003072-199110000-00011.
To evaluate a relationship between Gleason scores and Tc-99m HMDP bone imaging findings, data from 48 men (aged 45 to 77; mean, 67) with prostate carcinoma who had a bone imaging study at the time of presentation were reviewed. Cumulative Gleason scores were divided into two groups: high scores (6-10), 32 men; low scores (2-5), 16 men. Of the 32 men with high Gleason scores, 15 tested positive for multiple metastases and 17 tested negative. Tumors of the 16 men with low Gleason scores were negative for metastasis. A chi-square association between Gleason scores and the presence of metastases, either of a superscan pattern or multiple metastases, was 10.9 (1 df, P less than 0.001). The results indicate that a superscan pattern or multiple metastases were found exclusively in the bone images of patients with high histologic grades; bone images negative for metastases were associated with low-grade tumors. We conclude that positive bone imaging for metastases at the initial scan occurs only in patients who have high Gleason scores, that patients with high Gleason scores might or might not have skeletal metastasis, and that skeletal metastasis is not predictable in patients with low Gleason scores.
为评估 Gleason 评分与锝-99m 亚甲基二膦酸盐（HMDP）骨显像结果之间的关系，我们回顾了 48 例前列腺癌男性患者（年龄 45 至 77 岁；平均 67 岁）在就诊时进行骨显像研究的数据。累积 Gleason 评分分为两组：高分（6 - 10）组，共 32 例男性；低分（2 - 5）组，共 16 例男性。在 32 例 Gleason 高分患者中，15 例检测出多发转移呈阳性，17 例检测呈阴性。16 例 Gleason 低分患者的肿瘤转移呈阴性。Gleason 评分与转移的存在（无论是超级骨显像模式还是多发转移）之间的卡方关联度为 10.9（自由度为 1，P 值小于 0.001）。结果表明，超级骨显像模式或多发转移仅在高组织学分级患者的骨显像中出现；转移阴性的骨显像与低级别肿瘤相关。我们得出结论，初次扫描时骨显像转移呈阳性仅发生在 Gleason 高分患者中，Gleason 高分患者可能有或可能没有骨转移，并且 Gleason 低分患者的骨转移无法预测。
