Amoako Yaw Ampem, Hammond Emmanuel Nii Boye, Assasie-Gyimah Awo, Laryea Dennis Odai, Ankrah Alfred, Amoah George
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa.
Department of Nuclear Medicine Service, Korle Bu Teaching Hospital, Accra, Ghana, West Africa.
World J Nucl Med. 2019 Apr-Jun;18(2):143-148. doi: 10.4103/wjnm.WJNM_38_18.
We aimed to assess the relationship between bone scintigraphy findings and prostate-specific antigen (PSA) and Gleason score in a group of treatment naïve West Africans with prostate cancer. The age, PSA, and Gleason scores of 363 patients with prostate cancer were collected. Patients were risk stratified using the D'Amico criteria. Logistic regression was performed to assess the relationship between bone scan results and PSA and Gleason score. Receiver operating characteristics (ROC) analysis was used to determine the diagnostic reliability of the bone scan findings. Ninety of the 96 patients with metastases had high risk, and only 6 had low-to-intermediate risk disease ( = 0.0001). PSA (odds ratio [OR] 2.4 [95% confidence interval [CI] 1.5-3.8], = 0.001) and GS (OR 2.2 [95% CI 1.5-3.1], = 0.001) were independently predictive of the presence of metastases. ROC analysis revealed that PSA predicted the presence of metastases with an area under the curve of 0.72, and using a cut-off value of ≥20 predicted metastases with a sensitivity of 86.5% and specificity of 41.2%. A Gleason score of ≥7 had an 89.6% sensitivity and 34.8% specificity for bone metastases. Using a Gleason cutoff of ≥8, the sensitivity and specificity for predicting bone metastases were 54.2% and 71.5%, respectively. The area under the Gleason score ROC curve was 0.68. PSA and Gleason score are independent predictors of the presence of bone metastases in West Africans with prostate cancer.
我们旨在评估一组未经治疗的西非前列腺癌患者的骨闪烁扫描结果与前列腺特异性抗原（PSA）及 Gleason 评分之间的关系。收集了 363 例前列腺癌患者的年龄、PSA 和 Gleason 评分。采用达米科标准对患者进行风险分层。进行逻辑回归分析以评估骨扫描结果与 PSA 和 Gleason 评分之间的关系。采用受试者工作特征（ROC）分析来确定骨扫描结果的诊断可靠性。96 例有转移的患者中，90 例为高风险，只有 6 例为低至中度风险疾病（P = 0.0001）。PSA（优势比[OR] 2.4 [95%置信区间[CI] 1.5 - 3.8]，P = 0.001）和 Gleason 评分（GS）（OR 2.2 [95% CI 1.5 - 3.1]，P = 0.001）是转移存在的独立预测因素。ROC 分析显示，PSA 预测转移存在的曲线下面积为 0.72，使用≥20 的临界值预测转移的敏感性为 86.5%，特异性为 41.2%。Gleason 评分≥7 对骨转移的敏感性为 89.6%，特异性为 34.8%。使用 Gleason 临界值≥8，预测骨转移的敏感性和特异性分别为 54.2%和 71.5%。Gleason 评分 ROC 曲线下面积为 0.68。PSA 和 Gleason 评分是西非前列腺癌患者骨转移存在的独立预测因素。
