Can Prostate‐Specific Antigen Levels Predict Bone Scan Evidence of Metastases in Newly Diagnosed Prostate Cancer?
Can Prostate‐Specific Antigen Levels Predict Bone Scan Evidence of Metastases in Newly Diagnosed Prostate Cancer?
复制标题
前列腺特异性抗原水平可以预测新诊断前列腺癌的骨扫描转移证据吗？
DOI：
10.1097/00000421-199410000-00016
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
M. Blend
中科院分区：
文献类型：
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作者：
V. Vijayakumar;Srinivasan Vijayakumar;S. F. Quadri;M. Blend
前列腺癌的分期与任何其他癌症一样，在管理方面具有重大影响。目前，前列腺特异性抗原（PSA）测定和骨扫描是前列腺癌术前分期的两个重要步骤。PSA是一种非常有用的血清肿瘤标志物在前列腺癌患者的管理。我们回顾性评估了90例初次诊断为前列腺癌的患者，所有患者都进行了初始PSA水平测量以及骨扫描。除了PSA水平，我们还考虑了临床分期和病理分级在预测骨扫描转移时，在前列腺癌的初步诊断。PSA值< 10 ng/ml（27例患者）、临床分期A（9例患者）和病理分级1（19例患者）的阴性预测值为100%。PSA水平<10 ng/ml和>10 ng/ml的骨扫描转移证据的患者数量分别为0%（0/27例患者）和27%（17/63例患者）（p = 0.0022 [Fisher精确检验]; p = 0.003 [卡方检验]）。在分期（p = 0.688）、分级（p = 0.039）或PSA水平（p = 0.0001）较高的患者中，骨转移的发生率增加。然而，这三个参数都不能可靠地预测转移的骨扫描证据（即，阳性预测值）。当使用上述两个或三个参数的组合时，阴性预测值没有改善。
Staging in prostate cancer, as in any other cancer has significant ramifications in management. Currently, prostate-specific antigen (PSA) determination and the bone scan are two important procedures in the pretreatment staging workup of prostate cancer. PSA is a very useful serum tumor marker in the management of prostate cancer patients. We retrospectively evaluated 90 patients at the time of initial diagnosis of prostate cancer, all of whom had initial PSA levels measured, as well as bone scans obtained. In addition to the PSA level, we considered clinical stage and pathologic grade in the prediction of bone scan for metastases, at the time of initial diagnosis of prostate cancer. Negative predictive value for PSA values < 10 ng/ml (27 patients), clinical stage A (9 patients) and pathologic grade 1 (19 patients) was 100%. The number of patients with bone scan evidence of metastasis with <10 ng/ml and >10 ng/ml PSA levels were 0% (0/27 patients) and 27% (17/63 patients) (p = .0022 [Fisher's Exact test]; p = .003 [chi-square test]). In patients with higher stage (p = .688), grade (p = .039), or PSA levels (p = .0001), the incidence of bone metastases increased. However, none of these three parameters can predict reliably bone scan evidence of metastases (i.e., positive predictive value). The negative predictive values did not improve when a combination of the two or three of the above parameters were used.