国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2010年
6期
337-343
,共7页
黄诚刚%陈小艳%马春清%王俊红%苏莉%邓燕%牛文强
黃誠剛%陳小豔%馬春清%王俊紅%囌莉%鄧燕%牛文彊
황성강%진소염%마춘청%왕준홍%소리%산연%우문강
前列腺肿瘤%前列腺特异抗原%性腺激素类%99m锝美罗酸盐
前列腺腫瘤%前列腺特異抗原%性腺激素類%99m锝美囉痠鹽
전렬선종류%전렬선특이항원%성선격소류%99m득미라산염
Prostatic neoplasms%Prostate specific antigen Gonadal hormones%Techmetium Tc 99m Medronate
目的 探讨血清游离前列腺特异抗原(FPSA)、总前列腺特异抗原(TPSA)、FPSA/TPSA比值、血清催乳素、促卵泡激素(FSH)、促黄体激素(LH)、雌二醇、孕酮、睾酮的测定并结合99Tcm-MDP全身骨显像在前列腺癌诊断、前列腺良恶性疾病鉴别诊断及前列腺癌转移和复发中的临床价值.方法 采用罗氏电化学发光分析法测定44名健康男性、75例良性前列腺疾病[其中41例良性前列腺增生(BPH)、25例BPH伴急性尿潴留(BPH+AUR)者,9例急性前列腺炎(AP)]和48例经病理证实的前列腺癌患者血清催乳素、FSH、LH、雌二醇、孕酮、睾酮及TPSA、FPSA、FPSA/TPSA测定.用99Tcm-MDP对48例前列腺癌患者进行全身骨显像,分析各项指标对前列腺疾病诊断、鉴别诊断的临床价值.结果 ①前列腺癌及良性前列腺疾病患者TPSA、FPSA明显高于正常对照组(t1=11.42,t2=12.01,P＜0.01);②前列腺癌患者TPSA、FPSA明显高于良性前列腺疾病组(t1=10.69,t2=11.18,P＜0.01);③前列腺癌患者FPSA/TPSA比值明显低于BPH组(t=2.95,P＜0.01),但与BPH+AUR组及AP组之间无明显差异(t1=0.73,t2=0.62,P＞0.05).④前列腺癌患者FSH、LH明显高于良性前列腺疾病组及正常对照组,睾酮低于正常对照组和BPH组,而其他性腺激素催乳素、雌二醇、孕酮无显著差异(P＞0.05);⑤前列腺癌不同治疗方案的选择在治疗前后除根治术外,其他各组治疗前后FSH、LH、睾酮均有明显变化(FSH:t=4.01,P＜0.01;LH:t=2.46,P＜0.05;睾酮:t=3.20,P＜0.01);⑥有骨转移的前列腺癌患者TPSA、FPSA显著高于未发生骨转移者(tTPSA=5.38,tFPSA=4.26,P＜0.01),但FPSA/TPSA比值两者之间无显著差异(t=1.61,P＞0.05).结论 TPSA、FPSA在诊断前列腺癌、鉴别前列腺癌与良性前列腺疾病及判断骨转移等方面有着重要的临床价值;FPSA/TPSA＜0.16时前列腺癌发生的风险将增大,但不能独立用于诊断前列腺癌,TPSA、FPSA和性腺激素测定结合99Tcm-MDP全身骨显像对于前列腺癌的诊断、疗效观察和判断复发与转移有着重要的临床价值.
目的 探討血清遊離前列腺特異抗原(FPSA)、總前列腺特異抗原(TPSA)、FPSA/TPSA比值、血清催乳素、促卵泡激素(FSH)、促黃體激素(LH)、雌二醇、孕酮、睪酮的測定併結閤99Tcm-MDP全身骨顯像在前列腺癌診斷、前列腺良噁性疾病鑒彆診斷及前列腺癌轉移和複髮中的臨床價值.方法 採用囉氏電化學髮光分析法測定44名健康男性、75例良性前列腺疾病[其中41例良性前列腺增生(BPH)、25例BPH伴急性尿潴留(BPH+AUR)者,9例急性前列腺炎(AP)]和48例經病理證實的前列腺癌患者血清催乳素、FSH、LH、雌二醇、孕酮、睪酮及TPSA、FPSA、FPSA/TPSA測定.用99Tcm-MDP對48例前列腺癌患者進行全身骨顯像,分析各項指標對前列腺疾病診斷、鑒彆診斷的臨床價值.結果 ①前列腺癌及良性前列腺疾病患者TPSA、FPSA明顯高于正常對照組(t1=11.42,t2=12.01,P＜0.01);②前列腺癌患者TPSA、FPSA明顯高于良性前列腺疾病組(t1=10.69,t2=11.18,P＜0.01);③前列腺癌患者FPSA/TPSA比值明顯低于BPH組(t=2.95,P＜0.01),但與BPH+AUR組及AP組之間無明顯差異(t1=0.73,t2=0.62,P＞0.05).④前列腺癌患者FSH、LH明顯高于良性前列腺疾病組及正常對照組,睪酮低于正常對照組和BPH組,而其他性腺激素催乳素、雌二醇、孕酮無顯著差異(P＞0.05);⑤前列腺癌不同治療方案的選擇在治療前後除根治術外,其他各組治療前後FSH、LH、睪酮均有明顯變化(FSH:t=4.01,P＜0.01;LH:t=2.46,P＜0.05;睪酮:t=3.20,P＜0.01);⑥有骨轉移的前列腺癌患者TPSA、FPSA顯著高于未髮生骨轉移者(tTPSA=5.38,tFPSA=4.26,P＜0.01),但FPSA/TPSA比值兩者之間無顯著差異(t=1.61,P＞0.05).結論 TPSA、FPSA在診斷前列腺癌、鑒彆前列腺癌與良性前列腺疾病及判斷骨轉移等方麵有著重要的臨床價值;FPSA/TPSA＜0.16時前列腺癌髮生的風險將增大,但不能獨立用于診斷前列腺癌,TPSA、FPSA和性腺激素測定結閤99Tcm-MDP全身骨顯像對于前列腺癌的診斷、療效觀察和判斷複髮與轉移有著重要的臨床價值.
목적 탐토혈청유리전렬선특이항원(FPSA)、총전렬선특이항원(TPSA)、FPSA/TPSA비치、혈청최유소、촉란포격소(FSH)、촉황체격소(LH)、자이순、잉동、고동적측정병결합99Tcm-MDP전신골현상재전렬선암진단、전렬선량악성질병감별진단급전렬선암전이화복발중적림상개치.방법 채용라씨전화학발광분석법측정44명건강남성、75례량성전렬선질병[기중41례량성전렬선증생(BPH)、25례BPH반급성뇨저류(BPH+AUR)자,9례급성전렬선염(AP)]화48례경병리증실적전렬선암환자혈청최유소、FSH、LH、자이순、잉동、고동급TPSA、FPSA、FPSA/TPSA측정.용99Tcm-MDP대48례전렬선암환자진행전신골현상,분석각항지표대전렬선질병진단、감별진단적림상개치.결과 ①전렬선암급량성전렬선질병환자TPSA、FPSA명현고우정상대조조(t1=11.42,t2=12.01,P＜0.01);②전렬선암환자TPSA、FPSA명현고우량성전렬선질병조(t1=10.69,t2=11.18,P＜0.01);③전렬선암환자FPSA/TPSA비치명현저우BPH조(t=2.95,P＜0.01),단여BPH+AUR조급AP조지간무명현차이(t1=0.73,t2=0.62,P＞0.05).④전렬선암환자FSH、LH명현고우량성전렬선질병조급정상대조조,고동저우정상대조조화BPH조,이기타성선격소최유소、자이순、잉동무현저차이(P＞0.05);⑤전렬선암불동치료방안적선택재치료전후제근치술외,기타각조치료전후FSH、LH、고동균유명현변화(FSH:t=4.01,P＜0.01;LH:t=2.46,P＜0.05;고동:t=3.20,P＜0.01);⑥유골전이적전렬선암환자TPSA、FPSA현저고우미발생골전이자(tTPSA=5.38,tFPSA=4.26,P＜0.01),단FPSA/TPSA비치량자지간무현저차이(t=1.61,P＞0.05).결론 TPSA、FPSA재진단전렬선암、감별전렬선암여량성전렬선질병급판단골전이등방면유착중요적림상개치;FPSA/TPSA＜0.16시전렬선암발생적풍험장증대,단불능독립용우진단전렬선암,TPSA、FPSA화성선격소측정결합99Tcm-MDP전신골현상대우전렬선암적진단、료효관찰화판단복발여전이유착중요적림상개치.
Objective To evaluate the clinical value of free prostate antigen (FPSA) , total prostate specific antigen (TPSA) , FPSA / TPSA and serum hormones (PRL, FSH, LH, Prog, T, E2) combined with ECT bone imaging in patients with prostate carcinoma. Methods 44 healthy males, 75 patients of benign prostate disease (including 41 of benign prostatic hyperplasia (BPH) and 25 of HBP with acute urinary retention (BPH + AUR) surgery, 9 of acute prostatitis) , and 48 patients with prostate carcinoma were enrolled in this study. Their Gonadal hormones and TPSA, FPSA, FPSA / TPSA were measured. Results ①The level of TPSA and FPSA in patients with prostate carcinoma or benign prostate disease were significantly higher than in healthy control (t1=11.42, t2=12.01, P<0.01); ②hose in patients with prostate carcinoma were obviously higher than in patients with benign prostate disease (t1=10.69, t2=11.18, P<0.01); ③he ratio of FPSA/TPSA in patients with prostate carcinoma was obviously lower than those with BPH 0,=10.69, t2=11.18, P<0.01), but there were no significant differences between patients with BPH+AUR and acute prostatitis (t1=0.73, t2=0.62, P>0.05); ④he FSH and LH of gonadal hormones in patients with prostate carcinoma were obviously higher than in patients with benign prostate diseases and healthy control.鈶?Except patients having operation total correction, the gonadal hormones and FSH/LH, T in patients with prostate carcinoma having different treatment programs all had variances before and after therapy; ⑤TPSA and FPSA in patients with prostate carcinoma having bone metastasis were much higher than those without bone metastasis (t/TPSA=5.38, t/fpsA=4.26, P<0.01), the ratio of FPSA/TPSA between those two had no significant disparity (t=1.61, P>0.05). Conclusion here was great clinlical value of the determination of TPSA and FPSA in diagnosis of prostate carcinoma, identification of prostate carcinoma and benign prostate disease and in judgment of bone metastasis. The ratio of FPSA /TPSA <0.16 is a proper prediction index for diagnosis of prostate carcinoma, FPSA /TPSA might be <0.16 in healthy ones and patients with acute prostatitis or BPH ; but when FPSA / TPSA <0.16, the risk of prostate cancer would increase; Gonadal hormones is useful biomarkers in diagnosis and treatment in patients with prostate carcinoma.
