The Application of Radionuclide Bone Scintigraphy,Serum PSA and ALP Measurement in Diagnosis of Bone Metastasis in Prostate Cancer Patients

Objective To evaluate the clinical value of radionuclide bone scintigraphy,serum prostate-specific antigen(PSA) and alkaline phosphatase(ALP) measurement in the diagnosis of bone metastasis(BM) in prostate cancer patients.Methods The results of bone scans,serum PSA and ALP levels were reviewed in 37 patients with prostate cancer.Correlation analysis was performed between PSA,ALP levels and BM grade.Results The incidence rate of osseous metastasis was 70.3%(26/37),the most common involved parts were spine and pelvis.The serum PSA level in 18 untreated patients with BM was all 20 ng/ml,which was significantly different with those in 9 untreated patients without BM(NBM)(P0.01).For treated patients,there was no significant difference between BM and NBM patients when the cutoff value is 4ng/ml(P0.05),but significant difference could be received when the cutoff value is 0.4 ng/ml(P0.05).There was a positive correlation between serum ALP levels and BM degree(r=0.752,P=0.01).The levels of PSA in untreated and treated patients also had positive correlation with BM grade(r=0.508, P=0.01;r=0.515,P=0.05).Conclusion Radionuclide bone scintigraphy is major method in diagnosis of bone metastasis in prostate cancer patients currently.The levels of PSA ≥20 ng/ml in Patients with newly diagnosed and untreated prostate cancer should undergo bone scintigraphy.For those treated patients,bone scintigraphy should be performed when the PSA is ≥0.4 ng/ml.The diagnostic efficacy of ALP is better than that of PSA in untreated patients.The level of serum ALP is also correlates with the degree of BM.