Objective: To investigate the relationship between total prostate specific antigen (TPSA), free prostate specific antigen/total prostate specific antigen [RAT (F/T)], Gleason score, other factors and the whole-body bone plane imaging which was used to evaluate the bone metastasis of prostate cancer (PCa), and the diagnostic value of the abnormal concentration of bone imaging agent for single lesion. Methods: A retrospective analysis of (99)Tc(m)-methylene diphosphonate ((99)Tc(m)-MDP) whole-body bone imaging data of 93 patients with confirmed PCa in The First Hospital of Shanxi Medical University from Jan 2018 to Jan 2019 was conducted. The bone metastasis was diagnosed by whole-body bone imaging. The factors related to PCa bone metastasis, including age, TPSA, RAT (F/T), Gleason score were analyzed by Chi-square test and logistic two-class regression. The optimal cut-off point of TPSA was defined by receiver operating characteristic (ROC) curve. The region of interest (ROI) technique was used to repeatedly delineate the lesion (T) and the background area (NT) outside the bone and calculate the abnormal concentration value of bone imaging agent (T-NT)/NT, and the ROC curve was used to determine its diagnostic value. Results: The result of Chi-square analysis showed that Gleason score, TPSA and RAT (F/T) were associated with bone metastasis (P<0.05). Logistic regression analysis showed that TPSA and RAT (F/T) were associated with bone metastasis (P<0.01). TPSA >92.82 ng/ml was the best diagnosis for bone metastasis, and the sensitivity and specificity were 77.1% and 81.0%, respectively. There were 320 sites of high concentration of imaging agents in the whole-body bone imaging of PCa patients (194 in the metastatic group and 126 in the non-metastasis group). The (T-NT)/NT in the bone metastasis group was 7.11±0.29, the non-bone metastasis group was 2.69±0.20. (T-NT)/NT >3.52 was the best diagnosis for bone metastasis of single lesion, and the sensitivity and specificity were 86.1% and 80.2%, respectively. Conclusions: Gleason score, RAT (F/T) and TPSA are important risk factors of PCa bone metastasis. TPSA >92.82 ng/ml is the most supportive diagnosis for PCa bone metastasis. The abnormal concentration of bone imaging agent >3.52 owns the best diagnosis effect for the single lesion of PCa.
目的： 探讨总前列腺特异性抗原(TPSA)、游离前列腺特异性抗原/总前列腺特异性抗原[RAT(F/T)]和Gleason评分等因素与全身骨平面显像评价前列腺癌(PCa)骨转移之间的关系，以及骨显像剂异常浓聚程度对单发病灶的诊断价值。 方法： 回顾性分析2018年1月至2019年1月，就诊于山西医科大学第一医院的93例确诊PCa患者的(99)Tc(m)-亚甲基二膦酸盐((99)Tc(m)-MDP)全身骨平面显像资料，以全身骨平面显像诊断骨转移，采用logistic回归分析PCa骨转移的相关因素，包括年龄、TPSA、RAT(F/T)和Gleason评分，采用受试者工作特征(ROC)曲线明确TPSA的最佳临界值。利用感兴趣区域技术于平面图像上重复勾画病灶(T)和骨骼以外的本底区域(NT)，计算骨显像剂异常浓聚程度(T-NT)/NT，采用ROC曲线明确其诊断价值。 结果： 单因素分析显示，Gleason评分、TPSA和RAT(F/T)均与骨转移有关(均P<0.05)；logistic回归分析显示，TPSA和RAT(F/T)与骨转移有关(均P<0.01)。TPSA>92.82 ng/ml时，对骨转移诊断价值最佳，灵敏度和特异度分别为77.1%和81.0%。全身骨平面图像共计320个显像剂增高或浓聚灶，其中骨转移组194个，非骨转移组126个；骨转移组(T-NT)/NT为7.11±0.29，非骨转移组为2.69±0.20，当(T-NT)/NT>3.52时，对单发病灶的诊断最佳，灵敏度和特异度分别为86.1%和80.2%。 结论： Gleason评分、RAT(F/T)和TPSA为明确PCa骨转移的重要危险因素，TPSA>92.82 ng/ml时诊断价值最佳；当骨显像剂异常浓聚程度>3.52时，对PCa单发病灶的诊断效能最佳。.
Zhonghua zhong liu za zhi [Chinese journal of oncology]. 2020 Oct 23 [Epub]
Y Cheng, L P Luo, S Hu, L N Li, C Wu, B Wu, D W Wang
Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030001, China., Department of Magnetic Resonance, The First Hospital of Shanxi Medical University, Taiyuan 030001, China., Department of Urology, The First Hospital of Shanxi Medical University, Taiyuan 030001, China.