当前位置： SCI文献检索 > UROLOGY期刊下所有文献 > Ability of serum prostate-specific antigen levels to predict normal bone scans in patients with newly diagnosed prostate cancer.

Ability of serum prostate-specific antigen levels to predict normal bone scans in patients with newly diagnosed prostate cancer.

Abstract：

OBJECTIVES:To determine whether pretreatment serum prostate-specific antigen (PSA) levels in newly diagnosed prostate cancer patients can identify a group with a low probability of osseous metastasis and safely eliminate the need for a bone scan as a routine part of the staging evaluation. METHODS:We retrospectively reviewed 683 patients with prostate cancer between 1990 and 1993. Patients with prior therapy or serum PSA levels obtained longer than 3 months prior to bone scan were excluded. Bone scans were reviewed by two nuclear medicine physicians with a third deciding equivocal cases. RESULTS:Only 6% of 490 evaluable patients had a positive bone scan on initial evaluation. Scans were positive in 0 of 290 (0%) with PSA levels below 10 micrograms/L, 4 of 88 (4.5%) with PSA levels between 10 and 20 micrograms/L, and 24 of 112 (21%) with PSA levels above 20 micrograms/L. Although the risk of a positive bone scan increased with increasing PSA levels, PSA is a poor positive predictor of positive bone scans. The risk of a positive bone scan was 8% (5 of 64 patients) when PSA was between 20 and 50 micrograms/L, and increased to 40% (19 of 48 patients) for PSA levels greater than 50 micrograms/L. In contrast, serum PSA levels below 10 micrograms/L are strong negative predictors of positive bone scans, with no positive scans in 290 patients with PSA levels below 10 micrograms/L. Although the risk of a positive bone scan increased with increasing stage and grade, tumor stage and grade were poor negative predictors of positive bone scans. Up to 4% of patients with clinically confined or well-differentiated to moderately differentiated tumors had positive scans. Scans were positive in 12% of poorly differentiated tumors, but all these patients had PSA levels above 10 micrograms/L. CONCLUSIONS:Our data support the elimination of routine bone scintigraphy in patients with newly diagnosed prostate cancer and PSA levels below 10 micrograms/L. Bone scans are indicated when PSA levels are above 10 micrograms/L, or with T3 or poorly differentiated disease.

journal_name

Urology

journal_title

Urology

authors

Gleave ME,Coupland D,Drachenberg D,Cohen L,Kwong S,Goldenberg SL,Sullivan LD

doi

10.1016/s0090-4295(96)80016-1

subject

Has Abstract

pub_date

1996-05-01 00:00:00

pages

708-12

issue

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(96)80016-1

journal_volume

pub_type

杂志文章

在线工具

Ability of serum prostate-specific antigen levels to predict normal bone scans in patients with newly diagnosed prostate cancer.