fPSA、tPSA、PAP、fPSA/tPSA值联合99mTc-MDP骨扫描在前列腺癌诊断中的价值-现代医学

fPSA、tPSA、PAP、fPSA/tPSA值联合99mTc-MDP骨扫描在前列腺癌诊断中的价值

单位：三峡大学第一临床医学院附属医院、湖北省宜昌市中心人民医院

分类号：

出版年·卷·期（页码）：2013·41·第二期（92-95）

摘要：

目的：肿瘤标记物fPSA、tPSA、PAP、fPSA/tPSA比值联合99mTc-MDP骨扫描在前列腺癌诊断中的价值。方法：对175例初诊前列腺癌患者行99mTc-MDP骨扫描，并收集前列腺癌患者和88例正常人的血清标本，用化学发光法检测fPSA、tPSA，电化学发光法检测PAP，并计算出fPSA/tPSA比值。结果：在175例前列腺癌患者中，fPSA、tPSA、PAP均高于正常人，fPSA/tPSA比值低于正常人，有显著性差异（P<0.01）；fPSA、tPSA、PAP和fPSA/tPSA<0.20诊断前列腺癌的灵敏度分别为57.71%，69.14%，38.29%和66.29%，fPSA、tPSA和fPSA/tPSA<0.20三项联合检测灵敏性可达87.50%。99mTc-MDP骨扫描阳性病例占36.57%(64/175)，阴性病例占63.43％（111/175）。骨扫描阳性病例组的fPSA、tPSA和PAP均高于骨扫描阴性病例组（P<0.01）。当tPSA<10ng/ml时，骨扫描阳性病例数占29.87%，当tPSA>100ng/ml，骨扫描阳性病例数高达69.56%。结论：fPSA、tPSA、PAP和fPSA/tPSA<0.20可作为诊断前列腺癌的指标，联合检测可提高诊断前列腺癌的灵敏性。99mTc-MDP核素骨扫描可作为前列腺癌骨转移的筛查手段；随着tPSA增高，前列腺癌骨扫描阳性率逐渐增高。

Objective：To study the value of combination 99mTc-MDP bone scanning with serum tumor marker（fPSA、tPSA、PAP、the ratio of fPSA/tPSA） measurement in the patients with prostate cancer. Methods：99mTc-MDP whole-body bone scanning was performed in 175 patients with prostate cancer, the serum samples were collected in 175 patients and 88 comparison control group. fPSA、tPSA and PAP were measured by chemiluminescence technique, and calculating the ratio of fPSA/tPSA. Results：In 175 patients with prostate cancer，the average value of fPSA、tPSA and PAP were significantly higher than the control group(P<0.01). and the ratio of fPSA/tPSA was significantly lower than the control group(P<0.01). The sensitivity of fPSA, tPSA , PAP and fPSA/tPSA<0.20 in diagnosis prostate cancer were 57.71%，69.14%，38.29% and 66.29%. The sensitivity combining fPSA、tPSA and fPSA/tPSA<0.20 was 87.50%. The positive ratio of patietens with osseous metastasis was confirmed by 99mTc-MDP whole-body bone scanning was 36.57%(64/175)，and negative ratio was 63.43％（111/175）. When tPSA<10ng/ml，the positive ratio of patietens with osseous metastasis was confirmed by 99mTc-MDP whole-body bone scanning was 29.87%，but tPSA>100ng/ml，it was 69.56%. Conclusion：fPSA、tPSA、PAP and fPSA/tPSA<0.20 could become tumor marker of diagnosis prostate cancer，combining fPSA、tPSA and fPSA/tPSA<0.20 could increase the sensitivity. 99mTc-MDP whole-body bone scanning was considerable screening method in diagnosis osseous metastasis in the patients with prostate cancer, when tPSA increasing，the positive ratio of bone scanning in the patients with prostate cancer was higher and higher.

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