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目的:探讨碱性磷酸酶(ALP)、血钙和血红蛋白(Hb)在预测和诊断肾癌骨转移的价值.方法:纳入病理诊断为肾透明细胞癌且后期随访有骨转移的患者14例为骨转移组.同期按1:3匹配性别、年龄、肿瘤病理类型和随访时间,纳入肾癌无骨转移的患者42例为无骨转移组.分析两组之间各项指标的差异,明确肾癌骨转移的相关预测及诊断因素.结果:骨转移组患者的各项指标均显著高于无骨转移组(P＜0.05).二项式Logistic回归分析显示初诊肾癌ALP、骨转移后的ALP和骨转移独立相关(P＜0.05).ROC曲线显示初诊肾癌时患者ALP水平能较准确的预测骨转移风险(AUC=0.855),Cut-off值为108.5 U/L;后期随访患者ALP水平能较准确的诊断骨转移风险(AUC=0.927),Cut-off值为81.5 U/L.结论:初诊肾癌时,患者ALP＞108.5 U/L可预测后期发生骨转移的风险,肾癌后期随访的ALP＞81.5 U/L是判断患者是否合并骨转移的危险因素.“,”Objective:To explore the clinical significance of some risk factors for predicting or diagnosing bone metastases from renal cell cancer (RCC).Method:Fifty-six (14 cases of RCC with bone metastases and 42 cases without bone metastases) age-and sex-matched patients with renal clear cell carcinoma were included in this study.The correlations between clinical-pathological parameters and bone metastases from RCC were analyzed and risk factors for predicting or diagnosing bone metastases were identified.Result:The levels of alkaline phosphatase (ALP),calcium and hemoglobin (HB) were significantly higher in bone metastases group than those in non bone metastases (P＜0.05,respectively).Binary logistic regression analysis indicated the ALP of newly diagnosed patients,and ALP of patients in follow-up period were independent risk factors correlated with bone metastases (P ＜0.05,respectively).And these factors had comparable accuracy on predicting or diagnosing institutionalization (AUC of 0.855,0.927 respectively).The cut off values of it were 108.5 U/L,81.5 U/L respectively.Conclusion:For newly diagnosed patients,the concentrations of ALP＞108.5 U/L could be used as additional factors for determining the risk of developing bone metastases in RCC.Serum ALP＞81.5 U/L of patients in follow-up period may be used as a valuable biochemical marker to diagnose bone metastases in early stage.