White D R, Maloney J J, Muss H B, Vance R P, Barnes P, Howard V, Rhyne L, Cowan R J
JAMA. 1979 Sep 14;242(11):1147-9. doi: 10.1001/jama.242.11.1147.
A retrospective study of 146 patients with metastatic disease was undertaken to verify the clinical impression that radionuclide scanning rarely, if ever, discloses hepatic metastases in breast cancer patients with normal serum alkaline phosphatase (AP) levels. Only two of 39 patients with abnormal liver scans had normal AP levels, and we conclude that liver scans are not necessary as a routine screening method for liver metastases when the AP level is normal. In contrast AP levels were not predictive of bone scan results. All patients with a twofold or greater elevation of the AP level had abnormal bone, liver, or bone and liver scans. Routine AP determinations provide accurate staging information, and their proper use can decrease the cost of initial and follow-up examination of patients with breast cancer.
对146例转移性疾病患者进行了一项回顾性研究，以验证以下临床印象：在血清碱性磷酸酶（AP）水平正常的乳腺癌患者中，放射性核素扫描极少（如果有的话）能发现肝转移。39例肝脏扫描异常的患者中只有2例AP水平正常，我们得出结论，当AP水平正常时，肝脏扫描作为肝转移的常规筛查方法并非必要。相比之下，AP水平并不能预测骨扫描结果。所有AP水平升高两倍或更高的患者，其骨、肝或骨与肝扫描均异常。常规AP测定可提供准确的分期信息，合理使用可降低乳腺癌患者初始检查和后续检查的成本。
