中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
5期
443-445
,共3页
刘丹%王伟%乔庐东%郑宇朋%刘跃新%张光银%陈山
劉丹%王偉%喬廬東%鄭宇朋%劉躍新%張光銀%陳山
류단%왕위%교려동%정우붕%류약신%장광은%진산
前列腺肿瘤%骨肿瘤%肿瘤转移%放射性核素显像
前列腺腫瘤%骨腫瘤%腫瘤轉移%放射性覈素顯像
전렬선종류%골종류%종류전이%방사성핵소현상
Prostatic neoplasms%Bone neoplasms%Neoplasm metastasis%Radionuclide imaging
目的 探讨初发前列腺癌患者行骨扫描检查的指征.方法 回顾性分析我院2006年1月至2010年12月间确诊的95例初发前列腺癌患者临床资料,分析年龄、前列腺特异性抗原(PSA)水平、Glesaon评分、临床分期与骨扫描检查结果间的关系.结果 初发前列腺癌患者95例,其中骨扫描阳性33例(34.7％),阴性62例(65.3％).2组患者平均年龄分别为(74±7)岁和(76±7)岁,PSA水平分别为(70.7±38.1)ng/ml和(28.4±27.2) ng/ml,差异有统计学意义(t=-5.499,P=0.000).患者临床分期与骨扫描阳性相关(OR=4.684).Gleason评分＞7分,预测骨扫描阳性敏感度64％,特异度63％,阳性预测值48％,阴性预测值77％.PSA＞ 50 ng/ml预测骨扫描阳性的敏感度67％,特异度86％,阳性预测值71％,阴性预测值83％；临床分期＞T2的敏感度82％,特异度81％,阳性预测值69％,阴性预测值89％.结论 PSA≤10 ng/ml的初发前列腺癌患者可以不做骨扫描检查；PSA＞ 50 ng/ml者建议做骨扫描检查；10 ng/ml＜ PSA≤50 ng/ml时,如Gleason评分＞7分或者临床分期＞T2期者建议行骨扫描检查；同时满足PSA≤50 ng/ml、Gleason评分≤7分、临床分期≤T2期的初发前列腺癌患者可以不行核素骨扫描检查.
目的 探討初髮前列腺癌患者行骨掃描檢查的指徵.方法 迴顧性分析我院2006年1月至2010年12月間確診的95例初髮前列腺癌患者臨床資料,分析年齡、前列腺特異性抗原(PSA)水平、Glesaon評分、臨床分期與骨掃描檢查結果間的關繫.結果 初髮前列腺癌患者95例,其中骨掃描暘性33例(34.7％),陰性62例(65.3％).2組患者平均年齡分彆為(74±7)歲和(76±7)歲,PSA水平分彆為(70.7±38.1)ng/ml和(28.4±27.2) ng/ml,差異有統計學意義(t=-5.499,P=0.000).患者臨床分期與骨掃描暘性相關(OR=4.684).Gleason評分＞7分,預測骨掃描暘性敏感度64％,特異度63％,暘性預測值48％,陰性預測值77％.PSA＞ 50 ng/ml預測骨掃描暘性的敏感度67％,特異度86％,暘性預測值71％,陰性預測值83％；臨床分期＞T2的敏感度82％,特異度81％,暘性預測值69％,陰性預測值89％.結論 PSA≤10 ng/ml的初髮前列腺癌患者可以不做骨掃描檢查；PSA＞ 50 ng/ml者建議做骨掃描檢查；10 ng/ml＜ PSA≤50 ng/ml時,如Gleason評分＞7分或者臨床分期＞T2期者建議行骨掃描檢查；同時滿足PSA≤50 ng/ml、Gleason評分≤7分、臨床分期≤T2期的初髮前列腺癌患者可以不行覈素骨掃描檢查.
목적 탐토초발전렬선암환자행골소묘검사적지정.방법 회고성분석아원2006년1월지2010년12월간학진적95례초발전렬선암환자림상자료,분석년령、전렬선특이성항원(PSA)수평、Glesaon평분、림상분기여골소묘검사결과간적관계.결과 초발전렬선암환자95례,기중골소묘양성33례(34.7％),음성62례(65.3％).2조환자평균년령분별위(74±7)세화(76±7)세,PSA수평분별위(70.7±38.1)ng/ml화(28.4±27.2) ng/ml,차이유통계학의의(t=-5.499,P=0.000).환자림상분기여골소묘양성상관(OR=4.684).Gleason평분＞7분,예측골소묘양성민감도64％,특이도63％,양성예측치48％,음성예측치77％.PSA＞ 50 ng/ml예측골소묘양성적민감도67％,특이도86％,양성예측치71％,음성예측치83％；림상분기＞T2적민감도82％,특이도81％,양성예측치69％,음성예측치89％.결론 PSA≤10 ng/ml적초발전렬선암환자가이불주골소묘검사；PSA＞ 50 ng/ml자건의주골소묘검사；10 ng/ml＜ PSA≤50 ng/ml시,여Gleason평분＞7분혹자림상분기＞T2기자건의행골소묘검사；동시만족PSA≤50 ng/ml、Gleason평분≤7분、림상분기≤T2기적초발전렬선암환자가이불행핵소골소묘검사.
Objective To investigate the indication of bone scan for patients with newly diagnosed prostate cancer.Methods The clinical data of continual 95 patients with newly diagnosed prostate cancer was involved between January 2006 and December 2010. The relationship between age,PSA,Gleason scores,clinical stage and positive bone scans was respectively compared. Results The 33 patients (34.7％ ) with positive bone scans and 62 patients (65.3％) with negative bone scans.The mean age was ( 74 ± 7 ) years and ( 76 ± 7 ) years respectively in 2 groups respectively.PSA was ( 70.7 ± 38.1 ) ng/ml and ( 28.4 ± 27.2 ) ng/ml respectively,the difference was significant ( t =- 5.499,P =0.000).Clinical stage had positive correlation with positive bone scan,the OR value was 4.684.If the Gleason score ＞ 7,the sensitivity,specificity,positive predictive value and negative predictive value of positive bone scan was 64％,63％,48％ and 77％ respectively.If PSA ＞50 ng/ml,sensitivity,specificity,positive predictive value and negative predictive value was 67％,86％,71％ and 83％ respectively.If Clinical stage ＞T2,sensitivity,specificity,positive predictive value and negative predictive value was 82％,81％,69％ and 89％ respectively.Conclusions For patients with PSA≤10 ng/ml or simultaneously PSA≤50 ng/ml and Gleason score≤7 and clinical stage≤T2,bone scan is not necessary.Patients with newly diagnosed prostate cancer and PSA ＞ 50 ng/ml or Gleason score ＞ 7 or clinical stage ＞ T2 should undergo bone scan.
