Wang Yan, Zhang Xiao-Fei, Dai Ji, Zheng Yong-Chi, Zhang Ming-Gen, He Jian-Jun
The Medical Laboratory, Dujiangyan People's Hospital, Dujiangyan, 611830, China.
Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
J Huazhong Univ Sci Technolog Med Sci. 2013 Aug;33(4):559-562. doi: 10.1007/s11596-013-1158-z. Epub 2013 Aug 1.
This study aimed to evaluate the diagnostic and prognostic significance of serum bone sialoprotein (BSP) and prostate-specific antigen doubling time (PSADT) in patients with bone metastasis (BM) from prostate cancer (PC). A total of 116 patients with PC, 120 patients with benign prostatic hyperplasia (BPH) and 120 healthy controls were enrolled in this study. PC patients were divided into bone metastasis (BM) group (n=56) and non-bone metastasis (NBM) group (n=60). Serum BSP was detected by Sandwich ELISA. Severity of bone pain was evaluated using visual analogue score (VAS). Serum f-PSA and t-PSA levels were measured by using electrochemiluminescence immunoassay (ECLIA). PSADT was calculated according to the formula: PSADT=lg(2)/[log(PSA2)-log(PSA1)]. The mean serum BSP level in PC patients with BM was significantly higher than in PC patients without BM, BPH patients and controls (P<0.001 for all). Pearson's analysis showed that serum BSP level was positively correlated with VAS in PC patients with BM (P<0.05). Receiver operating characteristics (ROC) analysis demonstrated that BSP discriminated patients with BM from those without BM at the cutoff value of 33.26 ng/mL. The sensitivity and specificity were 78.21% and 79.28%, respectively. The optimal cutoff value of PSADT was 131 days, with sensitivity of 85.69% and specificity of 85.36%. Kaplan-Meier analysis revealed that subjects with higher BSP levels/shorter PSADT had a shorter BM-free period than those with lower BSP levels/longer PSADT. Serum BSP and PSADT are useful biomarkers for the diagnosis of BM from PC, and can be regarded as independent factors for predicting the prognosis of BM from PC. Combined determination of BSP and PSADT can improve accuracy and positive rate of BM from PC significantly.
本研究旨在评估血清骨唾液酸蛋白（BSP）和前列腺特异性抗原倍增时间（PSADT）在前列腺癌（PC）骨转移（BM）患者中的诊断和预后意义。本研究共纳入116例PC患者、120例良性前列腺增生（BPH）患者和120例健康对照。PC患者分为骨转移（BM）组（n = 56）和非骨转移（NBM）组（n = 60）。采用夹心酶联免疫吸附测定法（Sandwich ELISA）检测血清BSP。使用视觉模拟评分法（VAS）评估骨痛的严重程度。采用电化学发光免疫分析法（ECLIA）测定血清游离前列腺特异性抗原（f-PSA）和总前列腺特异性抗原（t-PSA）水平。PSADT根据公式计算：PSADT = lg(2)/[log(PSA2) - log(PSA1)]。PC伴BM患者的血清BSP平均水平显著高于无BM的PC患者、BPH患者和对照组（所有P<0.001）。Pearson分析显示，PC伴BM患者的血清BSP水平与VAS呈正相关（P<0.05）。受试者工作特征（ROC）分析表明，BSP在截断值为33.26 ng/mL时可区分有BM和无BM的患者。敏感性和特异性分别为78.21%和79.28%。PSADT的最佳截断值为131天，敏感性为85.69%，特异性为85.36%。Kaplan-Meier分析显示，BSP水平较高/PSADT较短的受试者无BM生存期短于BSP水平较低/PSADT较长的受试者。血清BSP和PSADT是诊断PC骨转移的有用生物标志物，可视为预测PC骨转移预后的独立因素。联合检测BSP和PSADT可显著提高PC骨转移的诊断准确性和阳性率。
