Wirtz D C, Wolff J M, Ittel T H, Jakse G, Niethard F U
Orthopädische Univ.-Klinik der RWTH Aachen.
Z Orthop Ihre Grenzgeb. 1998 May-Jun;136(3):255-9. doi: 10.1055/s-2008-1054232.
For patients with prostate cancer (CaP) the proof of osteoblastic bone metastases is decisive regarding the prognosis as well as the therapeutical concept. To evaluate the efficiency of skeletal alkaline phosphatase (SAP) as staging marker for bone metastases in prostate cancer, SAP was measured in CaP-patients with and without bone metastases compared with prostate-specific antigen (PSA) as the marker of choice till now.
73 patients with histological proven, but still untreated CaP were entered into the study. After staging the patients were divided into 3 groups: group I: patients with CaP and bone metastases (n = 21), group II: patients with locally advanced CaP without bone metastases (n = 26), group III: patients with clinically localized CaP without bone metastases (n = 26). Serum concentration for SAP and PSA were determined using radioimmunassay. As reference range we defined serum concentrations for SAP < 19 ng/ml and for PSA < 100 ng/ml.
71% of the patients with bone metastases (group I) showed elevated SAP and PSA serum concentrations. In contrast, patients without bone metastases (group II + III) have normal SAP-values (<19 ng/) and in 19% of the cases elevated PSA-values (>100 ng/ml). This resulted in a sensitivity and specificity of 71% and 100% for SAP and 71% and 81% for PSA. The positive predictive value for osteoblastic bone metastases was 100% for SAP and 60% for PSA.
SAP is a useful staging marker in prostate cancer and can contribute for an early detection of osteoblastic bone metastases.
对于前列腺癌（CaP）患者，成骨性骨转移的证据对于预后以及治疗方案具有决定性意义。为了评估骨碱性磷酸酶（SAP）作为前列腺癌骨转移分期标志物的有效性，将有骨转移和无骨转移的CaP患者的SAP水平与目前作为首选标志物的前列腺特异性抗原（PSA）进行比较。
73例经组织学证实但尚未接受治疗的CaP患者纳入本研究。分期后，患者分为3组：I组：有骨转移的CaP患者（n = 21），II组：局部晚期无骨转移的CaP患者（n = 26），III组：临床局限性无骨转移的CaP患者（n = 26）。采用放射免疫法测定血清SAP和PSA浓度。我们将SAP<19 ng/ml和PSA<100 ng/ml定义为参考范围。
骨转移患者（I组）中71%的患者血清SAP和PSA浓度升高。相比之下，无骨转移的患者（II组+III组）SAP值正常（<19 ng/），19%的患者PSA值升高（>100 ng/ml）。这使得SAP的敏感性和特异性分别为71%和100%，PSA的敏感性和特异性分别为71%和81%。SAP对成骨性骨转移的阳性预测值为100%，PSA为60%。
SAP是前列腺癌有用的分期标志物，有助于早期检测成骨性骨转移。
