中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2012年
5期
421-424
,共4页
前列腺肿瘤%肿瘤转移%前列腺特异抗原%骨
前列腺腫瘤%腫瘤轉移%前列腺特異抗原%骨
전렬선종류%종류전이%전렬선특이항원%골
Prostate neoplasms%Neoplasm metastasis%Prostate-specific antigen%Bones
目的 探讨前列腺特异性抗原(PSA)、骨形成标志物碱性磷酸酶(ALP)与骨吸收标志物抗酒石酸酸性磷酸酶5b(TRACP5b)、Ⅰ型胶原吡啶交联终肽(ICTP)在前列腺癌骨转移诊断的意义. 方法 通过测定57例老年前列腺癌患者(年龄61～90岁)PSA、TRACP5b、ALP、ICTP血清浓度,分成骨转移(27例)与非骨转移(30例)两组,以转移灶在5个及以上者划分为进展性(18例)和局限性骨转移(39例).采用受试者工作特征曲线( ROC)评估各标志物诊断前列腺癌骨转移的价值.结果 PSA、TRACP5b、ALP、ICTP血清浓度在前列腺癌骨转移组均高于非骨转移组(P＜0.05)；与局限性骨转移组比较,PSA、TRACP5b、ALP、ICTP、Gleason评分在进展性骨转移组中均有明显升高(P＜0.05)；PSA、TRACP5b、ALP、ICTP诊断前列腺癌骨转移的曲线下面积(AUC)分别为0.796、0.657、0.762、0.743,最高诊断价值的是PSA,ALP、ICTP与之相当,TRACP5b次之,其敏感性分别为66.7％、59.3％、37.0％、59.3％,特异性则为90.0％、96.7％、80.0％、76.7％；PSA、ALP、ICTP与Gleason评分是预测前列腺癌骨转移的独立性因素,总符合率为84.2％. 结论 PSA、TRACP5b、ALP、ICTP诊断前列腺癌骨转移的价值相当,联合检测并动态观察可能有利于前列腺癌骨转移的早期诊断.
目的 探討前列腺特異性抗原(PSA)、骨形成標誌物堿性燐痠酶(ALP)與骨吸收標誌物抗酒石痠痠性燐痠酶5b(TRACP5b)、Ⅰ型膠原吡啶交聯終肽(ICTP)在前列腺癌骨轉移診斷的意義. 方法 通過測定57例老年前列腺癌患者(年齡61～90歲)PSA、TRACP5b、ALP、ICTP血清濃度,分成骨轉移(27例)與非骨轉移(30例)兩組,以轉移竈在5箇及以上者劃分為進展性(18例)和跼限性骨轉移(39例).採用受試者工作特徵麯線( ROC)評估各標誌物診斷前列腺癌骨轉移的價值.結果 PSA、TRACP5b、ALP、ICTP血清濃度在前列腺癌骨轉移組均高于非骨轉移組(P＜0.05)；與跼限性骨轉移組比較,PSA、TRACP5b、ALP、ICTP、Gleason評分在進展性骨轉移組中均有明顯升高(P＜0.05)；PSA、TRACP5b、ALP、ICTP診斷前列腺癌骨轉移的麯線下麵積(AUC)分彆為0.796、0.657、0.762、0.743,最高診斷價值的是PSA,ALP、ICTP與之相噹,TRACP5b次之,其敏感性分彆為66.7％、59.3％、37.0％、59.3％,特異性則為90.0％、96.7％、80.0％、76.7％；PSA、ALP、ICTP與Gleason評分是預測前列腺癌骨轉移的獨立性因素,總符閤率為84.2％. 結論 PSA、TRACP5b、ALP、ICTP診斷前列腺癌骨轉移的價值相噹,聯閤檢測併動態觀察可能有利于前列腺癌骨轉移的早期診斷.
목적 탐토전렬선특이성항원(PSA)、골형성표지물감성린산매(ALP)여골흡수표지물항주석산산성린산매5b(TRACP5b)、Ⅰ형효원필정교련종태(ICTP)재전렬선암골전이진단적의의. 방법 통과측정57례노년전렬선암환자(년령61～90세)PSA、TRACP5b、ALP、ICTP혈청농도,분성골전이(27례)여비골전이(30례)량조,이전이조재5개급이상자화분위진전성(18례)화국한성골전이(39례).채용수시자공작특정곡선( ROC)평고각표지물진단전렬선암골전이적개치.결과 PSA、TRACP5b、ALP、ICTP혈청농도재전렬선암골전이조균고우비골전이조(P＜0.05)；여국한성골전이조비교,PSA、TRACP5b、ALP、ICTP、Gleason평분재진전성골전이조중균유명현승고(P＜0.05)；PSA、TRACP5b、ALP、ICTP진단전렬선암골전이적곡선하면적(AUC)분별위0.796、0.657、0.762、0.743,최고진단개치적시PSA,ALP、ICTP여지상당,TRACP5b차지,기민감성분별위66.7％、59.3％、37.0％、59.3％,특이성칙위90.0％、96.7％、80.0％、76.7％；PSA、ALP、ICTP여Gleason평분시예측전렬선암골전이적독립성인소,총부합솔위84.2％. 결론 PSA、TRACP5b、ALP、ICTP진단전렬선암골전이적개치상당,연합검측병동태관찰가능유리우전렬선암골전이적조기진단.
Objective To evaluate the significances of prostate specific antigen(PSA),alkaline phosphatase(ALP) as a marker of bone formation,tartrate-resistant acid phosphatase 5b(TRACP5b) and pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ICTP) as markers of bone resorption in diagnosis of bone metastasis of prostate cancer. Methods Totally 57 elderly patients aged 61-90 years with prostate cancer were divided into groups with bone metastasis(n=27)and without bone metastasis (n=30) according to radionuclide bone imaging,and into progressive(n=18) and limited metastasis groups(n=39) by EOD score.Serum concentrations of PSA,TRACP5b,ALP and ICTP were measured by electrochemiluminescence,colorimetric assay,enzyme-linked immunosorbent assays(ELISA).Sensitivities and specificities were calculated for each marker and the diagnostic values of markers were evaluated by receiver operating characteristic curve (ROC).Resuits The serum levels of PSA,TRACP5b,ALP and ICTP were significantly higher in group with bone metastasis than in group without metastasis (P＜ 0.05).In the progressive bone metastasis group,Gleason score and the concentrations of PSA,ALP,TRACP5b,ICTP were increased as compared with limited metastasis group (P＜ 0.05). In diagnosis of prostate cancer with bone metastasis,the area under ROC curve(AUC) of PSA,TRACP5b,ALP,ICTP were 0.796,0.657,0.762,0.743,respectively.The diagnostic value PSA,ALP and ICTP were comparable,followed by TRACP5b.Using the cut point values of 10.235 μg/L for PSA,4.25 U/L for TRACP5b,116.0 U/L for ALP and 7.6 U/L for ICTP,the sensitivities were 66.7％,59.3％,37％,59.3％ and the specificities were 90％,76.7％,96.7％,80％,respectively.PSA,ALP,ICTP and Gleason score were independent predictors of bone metastasis of prostate cancer,the total coincidence rate of regression model was 84.2％. Conclusions The diagnostic values of PSA,TRACP5b,ALP,ICTP are comparable,the combined and dynamic observation may facilitate early diagnosis of prostate cancer with bone metastasis.
