[骨扫描在新诊断前列腺癌患者中的应用指征]

[The indication of bone scan for patients with newly diagnosed prostate cancer].

作者信息

Liu Dan, Wang Wei, Qiao Lu-dong, Zheng Yu-peng, Liu Yue-xin, Zhang Guang-yin, Chen Shan

机构信息

Department of Urology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2012 May;50(5):443-5.

PMID:22883953

Abstract

OBJECTIVE

To investigate the indication of bone scan for patients with newly diagnosed prostate cancer.

METHODS

The clinical data of continual 95 patients with newly diagnosed prostate cancer was involved between January 2006 and December 2010. The relationship between age, PSA, Gleason scores, clinical stage and positive bone scans was respectively compared.

RESULTS

The 33 patients (34.7%) with positive bone scans and 62 patients (65.3%) with negative bone scans. The mean age was (74±7) years and (76±7) years respectively in 2 groups respectively. PSA was (70.7±38.1) ng/ml and (28.4±27.2) ng/ml respectively, the difference was significant (t=-5.499, P=0.000). Clinical stage had positive correlation with positive bone scan, the OR value was 4.684. If the Gleason score>7, the sensitivity, specificity, positive predictive value and negative predictive value of positive bone scan was 64%, 63%, 48% and 77% respectively. If PSA>50 ng/ml, sensitivity, specificity, positive predictive value and negative predictive value was 67%, 86%, 71% and 83% respectively. If Clinical stage>T2, sensitivity, specificity, positive predictive value and negative predictive value was 82%, 81%, 69% and 89% respectively.

CONCLUSIONS

For patients with PSA≤10 ng/ml or simultaneously PSA≤50 ng/ml and Gleason score≤7 and clinical stage≤T2, bone scan is not necessary. Patients with newly diagnosed prostate cancer and PSA>50 ng/ml or Gleason score>7 or clinical stage>T2 should undergo bone scan.

摘要

目的

探讨骨扫描在新诊断前列腺癌患者中的应用指征。

方法

纳入2006年1月至2010年12月期间连续95例新诊断前列腺癌患者的临床资料，分别比较年龄、前列腺特异抗原（PSA）、Gleason评分、临床分期与骨扫描阳性之间的关系。

结果

骨扫描阳性患者33例（34.7%），阴性患者62例（65.3%）。两组患者的平均年龄分别为（74±7）岁和（76±7）岁。PSA分别为（70.7±38.1）ng/ml和（28.4±27.2）ng/ml，差异有统计学意义（t=-5.499，P=0.000）。临床分期与骨扫描阳性呈正相关，比值比（OR）值为4.684。若Gleason评分>7，骨扫描阳性的灵敏度、特异度、阳性预测值和阴性预测值分别为64%、63%、48%和77%。若PSA>50 ng/ml，灵敏度、特异度、阳性预测值和阴性预测值分别为67%、86%、71%和83%。若临床分期>T2，灵敏度、特异度、阳性预测值和阴性预测值分别为82%、81%、69%和89%。