Clinical Value Of Radionuclide Bone Scan And PSA In Diagnosis Of Bone Metastasis In Prostate Cancer

Objective To investigate the clinical value of prostate specific antigen?PSA?in the diagnosis of PCa bone metastases in patients with radionuclide bone scan and prostate cancer?PCa?and to determine the radionuclide bone in patients with confirmed PCa bone metastases.The features of scan images and the data of cases were analyzed and summarized to improve the early diagnostic rate of prostate cancer with bone metastases.Methods The retrospective analysis of the 99mTc-Methylene Diphos Phonate(^99mTc-MDP)radionuclide bone scan and serum PSA in 90 patients diagnosed with PCa in our hospital from 2015 to 2017 were retrospectively analyzed.The bone scan results were used to grade all patients and were divided into four grades.Grade 0:normal bone scan,grade 1:1 to 2 metastatic lesions,grade 2:3 to 5 metastases,grade3:5 metastases.Grade 0 was negative for bone scans,and grades 1 to 3 were positive for bone scans.Analysis and statistics of radionuclide bone scan positive group imaging and clinical manifestations.At the same time,the serum PSA levels of patients were divided into 5 groups:PSA?10 ng/ml;PSA 11-20 ng/ml;PSA 21-60ng/ml;PSA 61-100 ng/ml;PSA>100 ng/ml.To determine the correlation and diagnostic value of serum PSA levels with radionuclide bone scan grading,in order to analyze the correlation between radionuclide bone scan results and PSA value and its diagnostic value;to use the Mann-Whitney U test to scan bone in PCa patients.The difference between the serum PSA value of the positive group and the serum PSA value of the negative group was compared;the serum PSA values of different bone scan grades were compared using the Cruskal-Wallis rank sum test;According to the Spear-man rank correlation test,it is judged whether the radionuclide bone scan grade has correlation with serum PSA.The test of accuracy comparison usesc² test.Results All of the 90 patients with PCa,69 were positive for bone scans,accounting for 76.67%;21 were negative for bone scans,accounting for 23.33%;among 69 patients with PCa bone metastases,60-80 years old had high age,single lesions Very few?7.25%?,most of them were multiple lesions?92.75%?.There were21 patients?23.33%?with grade 0 bone scan,19 patients?21.11%?with grade 1 bone scan,and 23 patients?25.56%?with grade 2 bone scan.In 27 patients?30.00%?with grade 3,PCa bone metastases had varying degrees of bone pain.Patients with persistent pain and intermittent pain were more common.The most common sites of pain were in the buttocks and waist;All patients with positive bone metastases had concomitant symptoms.The following urinary tract symptoms?dysuria,urinary frequency,urgency,and urinary retention?were the most common.The locations of metastatic sites were pelvis?28.53%?,spine?26.90%?,ribs?23.64%?,limbs?8.97%?,sternum?7.34%?,and skull?4.62%?.The bone metastasis was the proximal femur.For the.Of the patients who underwent PCa bone scan,69 patients had positive bone scans.The average serum PSA level was 85.79?77.50?ng/ml.In the negative bone scan group,21 patients had an average serum PSA level of 13.04?8.63?ng/ml;The difference in serum PSA between the group and the negative group was statistically significant?Z=-5.643,?<0.05?.The differences in serum PSA levels between different groups under different grades of radionuclide bone scans were statistically significant??<0.05?.Of the 10 patients with PSA?10ng/ml,3 had bone metastases?33.33%?;Of the 17 patients with PSA 11-20ng/ml,7 had bone metastases?41.17%?;At PSA 21-60ng/ml of the 15 patients,12 had bone metastases?80.00%?;Of the 19patients with PSA 61-100ng/ml,18 had bone metastases?94.74%?;29 had PSA>100ng/ml In all patients,all bone metastases occurred?100%?.With the increase in the radionuclide bone scan grade,serum PSA levels also increased,and serum PSA levels correlated with different grades of radionuclide bone scan??=0.778,?<0.05?.The difference in the positive rate of bone metastases detected by radionuclide bone scan between PSA 11-20ng/ml and PSA 21-60ng/ml was significant?c²=5.661,?<0.05?.Further studies found that the difference in the positive rate of PCa bone metastasis detected by nuclide bone scan at serum PSA?20 ng/ml and serum PSA>20 ng/ml was significant and statistically significant?c²=33.863,?<0.05?.Conclusions ?1?The occurrence of PCa bone metastases has certain characteristics and regularities.Nuclide bone scan examination combined with the analysis of case data has a certain significance for the early clinical diagnosis and treatment decision-making of PCa bone metastases.?2?Serum PSA levels in patients with PCa bone metastases are correlated with radionuclide bone scans.When serum PSA is less than 10 ng/ml,the probability of bone metastases is low.Serum PSA?20 ng/ml and serum PSA>20 ng/ml The radionuclide bone scan had a significant difference in the positive rate of PCa bone metastases diagnosis.Therefore,when PSA>20ng/ml,radionuclide bone scan is recommended to detect PCa bone metastasis early and comprehensively.