| Objective:1) Studying the correlation between serum Prostate specific antigen(Prostate specific antigen, PSA), Alkaline phosphatase(Alkaline phophatase, ALP) and bone imaging results.2) To study the change regulation of PSA and ALP before and after treatment of two phosphate in prostate cancer patients with multiple bone metastases.3) To study the application value of region of interest(ROI) semi-quantitative analysis method in the diagnosis of suspected into osseous metastasis of prostate cancer lesions Method:1) 206 cases of prostate cancer patients with bone scintigraphy, their ages ranged from50 to 94 years old(average 74.39 years old), and all the patients were performed during the same period of serum marker monitoring. 64 cases patients had untreated initial imaging,and their ages were 54-94 years old, with an average age of 73.63; 142 cases patients had initial imaging after comprehensive treament(34 cases of prostate cancer radical operation,77 cases of treated with endocrine, 31 cases of others), their ages were 50-92, average age73.76 years old. Based on the results of their bone imaging, Bone metastasis positive and negative were 41 and 23 in patients untreated at their initial imaging; positive and negative were 115 and 27 cases, at their first imaging of bone metastasis cancer after comprehensive.2) Based on the number of bone scintigraphy lesions, abnormal imaging agent concentration range and degree for the reference, the patient information was divided into into better, stability and progress group(18, 9,and 7 cases), analyse the changes betweenPSA and ALP before and after the treatment of two phosphonic acid salt improved after treatment.3) 121 patients with prostate cancer difficulted to be diagnosed, and 123 suspected lesions were performed by local CT fusion imaging. The pathology, follow-up or other imaging datas were as the reference, finally, 98 lesions were gathered, including 58 malignant diseases and 40 benign diseases. ROI semi-quantitative analysis was performed on all suspicious lesions, to study the diagnosis efficiency, the optimal cut-off values and the corresponding sensitivity and specificity of semi-quantitative analysis method of suspected metastatic bone lesions in prostate cancer.Results:1) Based on the presence of treatmentNon-treatment group and the treated groups of serum PSA, ALP were obviously different.The serum PSA, ALP levels in the treated groups were lower than that in no-treated group, and the difference had statistical significance(P < 0.05). Among different people, the correlation between PSA, ALP and imaging bone imaging results of had statistical significance(P < 0.05). The correlation coefficient is not treated people down in the treated groups were lower than that in no-treated people.2)Based on two phosphate treatment for the bone metastasesAfter treatment with bisphosphonates for prostate cancer with multiple bone metastasis, the changes of PSA and ALP were significant before and after treatment in both groups statistically, and among groups, the absolute value of the difference about PSA and ALP was also significant statistically(P<0.05).3)Based on tthe suspicious lesions from SPECT/CTThere were 58 osseous metastatic lesions,and 40 benign diseases. ROI semi quantitative analysis results showed that the average intake level(T/NT) of into osseous metastatic lesions in 99 mTc- MDP bone imaging was 5.33 ± 2.62, and benign lesions was2.01 ± 0.64. The difference was significant statistically(P < 0.05). In Local tomography(ct)fusion bone images, the uptaking level of 99 mTc- MDP about the suspicious osseous metastatic lesions had high diagnostic performance(area under the ROC curve for 0.951)in patients with prostate cancer. And when the 99 mTc- MDP uptaking ratio of suspicious osseous metastatic lesions was 2.94 or higher, the sensitivity and specificity was 90.2%and 76.9% respectively.Conclusion:1)Based on the presence of treatmentThe serum PSA, ALP levels in the treated groups were lower than that in no-treated people, and the correlation coefficient in the treated groups were lower than that in non-treatment group.2) Based on two phosphate treatment of multiple bone metastasisThe PSA and ALP level was different significantly before and after treatment among groups.3) Based on the suspicious lesions from SPECT/CTBone imaging and semi quantitative analysis method for prostate cancer suspicious osseous metastatic lesions had a high diagnostic efficiency, and the T / NT ≥ 2.94 of local fault fusion image focus, it had the most clinical application value. |
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