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目的:研究肿瘤标记物fPSA、tPSA、PAP、fPSA/tPSA值联合99mTc-MDP骨扫描在前列腺癌中的诊断价值。方法:对175例初诊前列腺癌患者行99mTc-MDP骨扫描,检测fPSA、tPSA和PAP,并计算出fPSA/tPSA值。结果:在175例前列腺癌患者中,fPSA、tPSA、PAP均高于正常人,fPSA/tPSA值低于正常人,差异有统计学意义(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<10 ng.ml-1时,骨扫描阳性病例数占29.87%,当tPSA>50 ng.ml-1,骨扫描阳性病例数高达58.97%。结论:fPSA、tPSA、PAP和fPSA/tPSA<0.20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 investigate the diagnostic value of tumor markers fPSA, tPSA, PAP, fPSA / tPSA combined with 99mTc-MDP bone scan in prostate cancer. METHODS: A total of 175 newly diagnosed prostate cancer patients underwent 99mTc-MDP bone scan. The fPSA, tPSA and PAP were measured and the fPSA / tPSA value was calculated. Results: The fPSA, tPSA, PAP were higher than those of normal people and the fPSA / tPSA values were lower than that of normal people in 175 cases of prostate cancer (P <0.01); fPSA, tPSA, PAP and fPSA / tPSA <0.20 The sensitivity of diagnosing prostate cancer were 57.71%, 69.14%, 38.29% and 66.29%, respectively. The sensitivity of three combined detection of fPSA, tPSA and fPSA / tPSA <0.20 was 87.50%. The positive rate of 99mTc-MDP bone scan was 36.57% (64/175), and the negative rate was 63.43% (111/175). The fPSA, tPSA and PAP in bone scan positive cases were higher than those in bone scan negative cases (P <0.01). At tPSA <10 ng.ml-1, the number of bone-scan positive cases accounted for 29.87%. When tPSA> 50 ng.ml-1, the number of bone-scan positive cases was 58.97%. Conclusion: The combined detection of fPSA, tPSA, PAP and fPSA / tPSA <0.20 may improve the sensitivity of diagnosis of prostate cancer. 99mTc-MDP nuclide bone scintigraphy can be used as a screening method for prostate cancer bone metastasis; with the increase of tPSA, the positive rate of prostate cancer bone scans increased gradually.