Serum PSA Level Combined With Gleason Score And Clinical Stage To Predict Radionuclide Bone Scan Findings In Patients With Prostate Cancer

Objective: To investigate the relationship between radionuclide bone scan and serum prostate-specific antigen (PSA),Gleason score, and clinical stage in prostate cancer.Methods: A survey has been made of inpatients with prostate cancer diagnosed by pathology from January 1992 to June 2005 in our hospital. Gleason score and clinical stage were determined on the basis of pathological examination and clinic material in prostate cancer patients. Positive predictive value (PPV) and negative predictive value (NPV) were compared among different groups based on PSA and Gleason score cut-off values in 117 patients. Logistic regression analyses were used to quantify the strength of association between positive scans and the available clinical variables.Results: The NPV and PPV of the low-risk group (PSA0～10ng/mL, Gleason score<8) and the high-risk group (PSA>100ng/mL, Gleason score>7)are 100%, 71% and42%,93%, respectively. In univariate and multivariate analysis, serum PSA level, Gleason score and clinical stage are all independently predictive of a positive bone scan. The strongest predictor of a positive scan was serum PSA levels, especially the presence of serum PSA levels of 100.1-500 ng/mL, the next strongest predictor was clinical stage T3, T4.Conclusions: Radionuclide bone scans are an unnecessary part of staging of prostate cancer if PSA<10ng/mL, especially with stage T1, T2 and Gleason score <8. There is almost bone metastasis if PSA>100ng/mL especially with stage T3, T4 and Gleason score >7.