Murphy G P, Troychak M J, Cobb O E, Bowes V A, Kenny R J, Barren R J, Kenny G M, Ragde H, Holmes E H, Wolfert R L
Cancer Research Division, Pacific Northwest Cancer Foundation, Northwest Hospital, Seattle, Washington 98125, USA.
Prostate. 1997 Oct 1;33(2):141-6. doi: 10.1002/(sici)1097-0045(19971001)33:2<141::aid-pros8>3.0.co;2-n.
Metastatic prostate cancer clinical evaluation is difficult. A revaluation of new prostate markers with regard to bone scans was performed.
Serial markers, including bone alkaline phosphatase (BAP), total alkaline phosphatase (TAP), prostate-specific antigen, total (PSA) and free (fPSA), and prostate-specific membrane antigen (PSMA), were obtained in patients under evaluation and treatment for possible or known metastatic prostate cancer. These were correlated with bone scan results (BSR).
Seventy patients were observed from mid-October 1996-January 1997, during which time 171 serum samples were obtained and correlated with semiquantitative bone scan status. PSA and fPSA provided some correlation with BAP and BSR, but only at high levels (> 16-50 ng/ml). Receiver-operating curve (ROC) analysis demonstrated that BAP and TAP had a significant discriminating ability for positive and negative bone scans (> .78), compared to PSMA, PSA, and fPSA. However, percent BAP and TAP only correlated with BSR at a level above six lesions. As the lesions detected by BSR increased, the correlation increased.
BAP is a valuable marker for clinical response evaluations to use in the serial follow-up of patients with metastatic prostate cancer, and correlates well with the bone scan as the number of lesions increase to > 6. PSA or fPSA show comparable results, but only at high levels (> 16-50 ng/ml).
转移性前列腺癌的临床评估具有挑战性。我们针对骨扫描对新的前列腺标志物进行了重新评估。
在对可能患有或已知患有转移性前列腺癌的患者进行评估和治疗过程中，获取了一系列标志物，包括骨碱性磷酸酶（BAP）、总碱性磷酸酶（TAP）、总前列腺特异性抗原（PSA）、游离前列腺特异性抗原（fPSA）以及前列腺特异性膜抗原（PSMA）。将这些标志物与骨扫描结果（BSR）进行关联分析。
1996年10月中旬至1997年1月期间观察了70例患者，在此期间获取了171份血清样本，并与半定量骨扫描状态进行关联。PSA和fPSA与BAP及BSR存在一定关联，但仅在高水平时（>16 - 50 ng/ml）。受试者操作特征曲线（ROC）分析表明，与PSMA、PSA和fPSA相比，BAP和TAP对骨扫描阳性和阴性结果具有显著的鉴别能力（>.78）。然而，BAP和TAP百分比仅在骨病变超过6个时才与BSR相关。随着BSR检测到的病变数量增加，相关性增强。
BAP是用于转移性前列腺癌患者系列随访中临床反应评估的有价值标志物，并且随着病变数量增加至>6个时与骨扫描相关性良好。PSA或fPSA在高水平时（>16 - 50 ng/ml）显示出类似结果。
