骨闪烁显像作为一种新的成像生物标志物：骨转移前列腺癌患者骨扫描指数与骨代谢标志物的关系。

Bone scintigraphy as a new imaging biomarker: the relationship between bone scan index and bone metabolic markers in prostate cancer patients with bone metastases.

机构信息

Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan,

出版信息

Ann Nucl Med. 2013 Nov;27(9):802-7. doi: 10.1007/s12149-013-0749-x. Epub 2013 Jul 5.

DOI:10.1007/s12149-013-0749-x

PMID:23828554

Abstract

OBJECTIVE

A computer-aided diagnosis system for bone scintigraphy with a semiquantitative index from the Bone Scan Index (BSI) has been used to quantify the spread of bone metastases. However, few papers have made clear associations among BSI, bone metabolic markers, and prostate-specific antigen (PSA). This retrospective study aimed to examine these relationships in prostate cancer patients with bone metastases.

METHODS

A total of 158 scans from 52 patients (number of median examinations/person 3, range 1-8; median age 71 years, age range 46-86) were included. The intervals between bone scans and blood examinations were 0-16 days (median 0 day). The serum markers of PSA, pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (1-CTP), bone alkaline phosphatase (BAP), and tartrate-resistant acid phosphatase-5b (TRACP-5b) were examined. Subjects were divided into 4 groups according to BSI; Group A: 0 to <2, Group B: 2 to <4, Group C: 4 to <8, and Group D: over 8. BSI, which corresponded to the amount of metastatic lesion, was automatically calculated by BONENAVI(®) software (FUJIFILM RI Pharma, Co. Ltd., Tokyo, Japan; Exini Bone, Exini Diagnostics, Sweden).

RESULTS

All bone scans showed high uptake with bone metastases. BSI was correlated significantly with the serum 1-CTP, serum BAP, serum TRACP-5b, logBAP, logTRACP-5b, and logPSA (r = 0.39, 0.66, 0.69, 0.71, 0.62 and 0.41, respectively). BSI did not correlate significantly with the serum PSA. The statistical F value was 11 in the serum 1-CTP, 31 in serum BAP, 29 in logBAP, 19 in serum TRACP-5b, 14 in logTRACP-5b, 3 in serum PSA, and 9 in logPSA by analysis of variance. Comparison by Dunnett's test showed significantly higher values in Group D for all original bone metabolic markers and the logPSA, Group C for the serum BAP, logBAP, serum TRACP-5b, and logTRACP-5b, and Group B for the logTRACP-5b compared with Group A.

CONCLUSION

The changes in BSI showed a close relationship with all bone metabolic markers but not with the serum PSA. The BSI is confirmed to reflect the activity and extent of bone metastases, and can be used as an imaging biomarker.

摘要

目的

我们使用一种具有半定量指标的骨扫描指数（BSI）的计算机辅助诊断系统来量化骨转移的扩散。然而，很少有文献清楚地将 BSI、骨代谢标志物和前列腺特异性抗原（PSA）联系起来。本回顾性研究旨在检查前列腺癌骨转移患者的这些关系。

方法

共纳入 52 例患者的 158 个扫描图像（每位患者的中位数检查次数/人 3 次，范围 1-8 次；中位数年龄 71 岁，年龄范围 46-86 岁）。骨扫描和血液检查之间的时间间隔为 0-16 天（中位数 0 天）。检查了 PSA、I 型胶原吡啶交联羧基末端肽（1-CTP）、骨碱性磷酸酶（BAP）和抗酒石酸酸性磷酸酶-5b（TRACP-5b）等血清标志物。根据 BSI 将患者分为 4 组：A 组：0 至<2，B 组：2 至<4，C 组：4 至<8，D 组：>8。BSI 通过 BONENAVI（®）软件（FUJIFILM RI Pharma，Co.，Ltd.，东京，日本；Exini Bone，Exini Diagnostics，瑞典）自动计算，与转移性病变的数量相对应。

结果

所有骨扫描均显示骨转移高摄取。BSI 与血清 1-CTP、血清 BAP、血清 TRACP-5b、logBAP、logTRACP-5b 和 logPSA 呈显著正相关（r=0.39、0.66、0.69、0.71、0.62 和 0.41）。BSI 与血清 PSA 无显著相关性。方差分析的统计 F 值分别为血清 1-CTP 为 11，血清 BAP 为 31，logBAP 为 29，血清 TRACP-5b 为 19，logTRACP-5b 为 14，血清 PSA 为 3，logPSA 为 9。Dunnett 检验结果表明，与 A 组相比，D 组所有原始骨代谢标志物和 logPSA、C 组血清 BAP、logBAP、血清 TRACP-5b 和 logTRACP-5b、B 组 logTRACP-5b 均显著升高。