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目的探讨BALP在诊断前列腺癌发生骨转移的意义。方法50例前列腺癌患者中有40例有多发生骨转移灶。另外10例未发生骨转移为病理对照组。我们以骨显像加日后3-5个月追踪的CT、X线检测综合判断为金标准,并根据骨显像将骨转移分成3个等级,ELISA检测患者的PSA、BALP,应用硝基苯磷酸盐法测血中ALP活性,并统计应用不同方法诊断的敏感度和特异度。结果骨转移组外周血PSA、ALP、BALP水平均显著高于对照组(P<0.05),PSA、ALP、BALP浓度或活性变化均与骨转移的不同分级呈正相关(r=0.789,0.814,0.912;P=0.041,0.035,0.011),在诊断的敏感性和特异性的比较中,骨显像诊断的敏感度最高,可以达到95%,但是其特异度最低只有40%;而骨显像+BALP敏感度最低为52.5%;但是可以提高特异度可以达到100%。结论BALP在诊断前列腺癌发生骨转移中特异性较强,联合检测BALP+骨显像可以提高诊断特异度。
Objective To investigate the significance of BALP in the diagnosis of bone metastasis of prostate cancer. Methods 50 cases of prostate cancer in 40 cases of patients with multiple bone metastases. The other 10 cases did not have bone metastasis as pathological control group. We use bone imaging plus 3-5 months follow-up of CT, X-ray detection of comprehensive judgment as the gold standard, and according to bone imaging will be divided into three grades of bone metastasis, ELISA detection of patients with PSA, BALP, nitrobenzene ALP activity measured by phosphate method, and statistical sensitivity of different methods of diagnosis and specificity. Results The levels of serum PSA, ALP and BALP in bone metastasis group were significantly higher than those in control group (P <0.05). The changes of PSA, ALP and BALP concentration or activity were positively correlated with different grades of bone metastasis (r = 0.789,0.814,0.912 ; P = 0.041,0.035,0.011), in the diagnosis of sensitivity and specificity of the comparison, the highest sensitivity of bone imaging diagnosis, up to 95%, but the lowest specificity of only 40%; and bone imaging + The lowest BALP sensitivity is 52.5%; however, the specificity can be increased to 100%. Conclusion The specificity of BALP in the diagnosis of bone metastasis of prostate cancer is strong. Combined detection of BALP + bone imaging can improve the diagnostic specificity.