Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press36410.17650/1726-9776-2012-8-4-70-76PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫTHE ROLE OF BONE SCINTIGRAPHY IN DETECTION OF BONE METASTASES OF PROSTATE CANCER IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMYРОЛЬ ОСТЕОСЦИНТИГРАФИИ В ДИАГНОСТИКЕ МЕТАСТАТИЧЕСКОГО ПОРАЖЕНИЯ КОСТЕЙ СКЕЛЕТА У ПАЦИЕНТОВ С БИОХИМИЧЕСКИМ РЕЦИДИВОМ ПОСЛЕ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ ПО ПОВОДУ РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫDemeshkoP. D.ДемешкоП. Д.
Belarus
pdemeshko@me.comSukonkoO. G.СуконкоО. Г.
Belarus
pdemeshko@me.comKrasnyS. A.КрасныйС. А.
Belarus
pdemeshko@me.comN.N. Alexandrov National Cancer Center of Belarus, Minsk, Republic of BelarusРНПЦ онкологии и медицинской радиологии им. Н.Н. Александрова, Минск, Республика Беларусь301220128470760808201408082014https://oncourology.abvpress.ru/oncur/article/view/364

Objective: to evaluate the relationship between serum PSA and other variables to eliminate bone scanning (BS) in patients with biochemical recurrence (BR) after radical prostatectomy (RP) having a low probability of bone metastasis.

Material and methods. The study included 110 patients with BR after RPE between 2008 and 2012. Bone metastasis was studied for its correlation with various clinical and pathological variables in these patients.

Results. According to multivariate regression analysis the trigger PSA level, PSA doubling time and Gleason sum were independent predictors of detecting of bone metastases using scintigraphy. The frequency of bone metastases was 0 % (95% CI 0,0−14,3) in patients with PSA 5 ng/mL, PSA doubling time 6 month and Gleason sum after RP 6.

 Conclusion. For patients with trigger PSA levels of 5 ng/ml or lower, PSA doubling time 6 month or less and Gleason sum 6 or less, BS may be eliminated because of the negligible risk of bone metastases.

Цель исследования – оценка возможностей остеосцинтиграфии (ОС) в диагностике метастатического поражения костей скелета у пациентов с биохимическим рецидивом (БР) после радикальной простатэктомии (РПЭ) по поводу рака предстательной железы (РПЖ).

Материалы и методы. В проспективное исследование включены данные 110 пациентов, проходивших обследование в РНПЦ ОМР им. Н.Н. Александрова в период с 2008 по 2012 г. по поводу БР после РПЭ. Для определения предсказательной значимости различных факторов относительно результатов ОС выполнены моновариантный и мультивариантный регрессионные логистические анализы. Для оценки информативности ОС вычислена частота выявления метастазов в костях в зависимости от сочетания независимых факторов прогноза.

Результаты и выводы. По результатам мультивариантного регрессионного анализа уровень простатспецифического антигена (ПСА) после РПЭ, время его удвоения и степень злокачественности опухоли по данным послеоперационного исследования являлись независимыми предикторами выявления метастазов в костях с применением ОС. Частота выявления костных метастазов при уровне ПСА 5 нг/мл, времени его удвоения 6 мес и сумме баллов по шкале Глисона 6 составила 0 (95 % доверительный интервал (ДИ) 0,0−14,3), что обусловливает возможность исключения ОС из обязательного объема обследований данной категории пациентов. Частота выявления метастазов с помощью ОС в группе высокого риска составила 92,3 % (95 % ДИ 64,6−99,9).

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