[Correlation of prostatic specific antigen, tumor grade, and local stage with bone scintigraphy in the staging of patients with prostatic cancer].
OBJECTIVE
To determine the capacity of PSA, tumor grade and local stage to predict the bone scintiscan findings in patients with newly diagnosed, untreated prostate cancer.


METHODS
We analyzed the records of 189 patients with prostate cancer that had been seen at our institution from January, 1993 to September, 1995. PSA determination was performed prior to biopsy, local staging by DRE or transrectal US was done and they had a bone scintiscan before treatment.


RESULTS
21% of the patients had metastasis. Univariate analysis showed PSA (p < 0.001), tumor grade (p = 0.01) and local stage (p = 0.001) independently predicted the positive bone scintiscans. However, multivariate regression analysis showed tumor grade (rc = 0.05) or stage (rc = 0.07) did not increase the predictive value of PSA (rc = 0.22). The highest negative predictive value of PSA [95% (IC95 = 87.5%, 98.6%)] was obtained when 20 ng/ml was used as cutoff. Therefore 1.4% to 13.5% of the patients with bone metastasis could not have been diagnosed without scintigraphy.


CONCLUSIONS
Bone scintigraphy should be performed routinely to determine the extent of the lesion in patients with prostatic cancer, particularly in those patients that are likely to undergo radical treatment.
Herranz Amo
F
F
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Díez Cordero
J M
JM
Verdú Tartajo
F
F
Lledó García
E
E
Subirá Castillón
C
C
González Chamorro
F
F
Rodríguez Fernández
E
E
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D011877:Radionuclide Imaging; D012044:Regression Analysis; D012189:Retrospective Studies
D017430:Prostate-Specific Antigen
Correlación entre el antígeno específico prostático, el grado tumoral y el estadio local con la gammagrafía ósea en el estadadiaje de los pacientes con cáncer de próstata.