Wolff J M, Ittel T, Boeckmann W, Reinike T, Habib F K, Jakse G
Department of Urology, Rheinisch-Westfälische Technische Hochschule Aachen, Germany.
Eur Urol. 1996;30(3):302-6. doi: 10.1159/000474187.
To compare the efficacy of two tests, prostate-specific antigen (PSA) and skeletal alkaline phosphatase (SAP) as staging markers to discriminate patients with cancer of the prostate (CaP) with bone metastases (M+) from those without bone metastases (M0).
Thirty-nine untreated patients with CaP M0 (n = 22) and CaP M+ (n = 17) along with 10 patients with benign prostatic hyperplasia, who served as controls, were entered in this study. Serum concentrations for SAP and PSA were determined using two immunoassays. Receiver operating characteristic (ROC) curves were constructed to compare the ability of SAP and PSA to discriminate patients with CaP M+ from CaP M0.
None of the M0 patients but 65% of the M+ patients exhibited an SAP value above the reference range (< 19 ng/ml). A corresponding cutoff point of 100 ng/ml for PSA demonstrated that 27% of M0 patients and only 65% of the M+ patients exhibited a value > 100 ng/ml. This resulted in a sensitivity of 65% for both markers. However, SAP revealed a higher specificity than PSA (100 vs. 73%). The ROC curve comparing SAP and PSA demonstrated the superiority of SAP as a marker for bone metastases.
Our findings suggest that SAP could become a useful marker in the evaluation of patients with newly diagnosed CaP as it seems to provide additional information concerning the skeletal status of these patients.
比较两种检测方法——前列腺特异性抗原（PSA）和骨碱性磷酸酶（SAP）作为分期标志物，用于鉴别前列腺癌（CaP）伴骨转移（M+）患者与无骨转移（M0）患者的疗效。
39例未经治疗的CaP M0患者（n = 22）和CaP M+患者（n = 17）以及10例良性前列腺增生患者作为对照纳入本研究。采用两种免疫测定法测定血清中SAP和PSA的浓度。构建受试者工作特征（ROC）曲线，比较SAP和PSA鉴别CaP M+患者与CaP M0患者的能力。
M0患者中无一例SAP值高于参考范围（< 19 ng/ml），但M+患者中有65%高于此范围。PSA的相应临界值为100 ng/ml时，27%的M0患者和仅65%的M+患者的值> 100 ng/ml。这导致两种标志物的敏感性均为65%。然而，SAP显示出比PSA更高的特异性（100%对73%）。比较SAP和PSA的ROC曲线表明，SAP作为骨转移标志物具有优越性。
我们的研究结果表明，SAP可能成为评估新诊断CaP患者的有用标志物，因为它似乎能提供有关这些患者骨骼状况的额外信息。
