Singh O P, Yogi Veenita, Redhu Pallavi, Ghori H U, Pareek Ananya, Lal Nancy
Department of Radiation Oncology, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
J Cancer Res Ther. 2019 Mar;15(Supplement):S39-S41. doi: 10.4103/jcrt.JCRT_189_18.
Prostate cancer is most frequently diagnosed cancer of men and bone is the most common site of metastasis. There is a lack of consensus for the selection criteria for bone scan in low-risk patients. Western guidelines do not recommend use of bone scan in asymptomatic patients and in low prostate-specific antigen (PSA) values. We try to correlate the PSA value with bone metastases through bone scan in the Indian population.
A total of 68 histologically newly diagnosed prostate cancer subjected to bone scan were retrospectively analyzed. The patients were stratified into four groups according to their PSA level: The first group of patients had PSA level ranging from 0 to 10 ng/ml (n = 4), the second group had PSA level ranging from 10.1 to 20 ng/ml (n = 13), the third group had PSA levels 20.1-100 ng/ml (n = 23), and the fourth group has PSA >100 (n = 28).
The incidence of osseous metastases proven by bone scan was found to be zero (0 out of 4) for PSA level 0-10 ng/ml; 38.46% (5 out of 13) for PSA level 10.1-20, 60.87% (14 out of 23) for PSA level 20.1-100 ng/ml, and 100% for PSA >100 (P < 0.005) (95% confidence interval 1.01-1.1). For cut-off value of PSA ≤10 ng/ml, sensitivity and specificity were 100% and 19.05%, respectively, with positive predictive value of 73.44%.
The correlation between PSA value and presence of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The screening bone scan at initial diagnosis should be included for all patients with PSA >10 ng/ml in Indian setting.
前列腺癌是男性中最常被诊断出的癌症，而骨骼是最常见的转移部位。对于低风险患者骨扫描的选择标准缺乏共识。西方指南不建议对无症状患者和前列腺特异性抗原（PSA）值较低的患者进行骨扫描。我们试图通过对印度人群进行骨扫描，将PSA值与骨转移情况相关联。
对总共68例经组织学新诊断为前列腺癌并接受骨扫描的患者进行回顾性分析。根据患者的PSA水平将其分为四组：第一组患者的PSA水平为0至10 ng/ml（n = 4），第二组的PSA水平为10.1至20 ng/ml（n = 13），第三组的PSA水平为20.1 - 100 ng/ml（n = 23），第四组的PSA > 100（n = 28）。
骨扫描证实的骨转移发生率在PSA水平为0 - 10 ng/ml时为零（4例中0例）；PSA水平为10.1 - 20时为38.46%（13例中5例），PSA水平为20.1 - 100 ng/ml时为60.87%（23例中(14)例），PSA > 100时为100%（P < 0.005）（95%置信区间1.01 - 1.1）。对于PSA≤10 ng/ml的临界值，敏感性和特异性分别为100%和19.05%，阳性预测值为73.44%。
PSA值与转移灶存在之间的相关性证实了骨扫描闪烁显像在前列腺癌分期中的有用性。在印度，对于所有PSA > 10 ng/ml的患者，初始诊断时应进行筛查骨扫描。
