Value of prostate specific antigen in predicting the existence of bone metastasis in scintigraphy.
OBJECTIVE
Evaluate the ability of serum concentration of prostate specific antigen (PSA) between 2 cutting points to predict the existence of bone metastasis confirmed by bone scintigraphy in man with prostate cancer.


METHODS
Two hundred and fourteen consecutive patients with prostate cancer were evaluated during the present study in the period from 1998 to 2001. From all patients, PSA serum concentrations and bone scintigraphy were obtained. For the study, 2 cutting points of PSA (10 and 20 ng/mL) were adopted to predict the existence of bone metastasis.


RESULTS
From the 214 patients, 35 (16.3 x 0025;) presented positive scintigraphic examinations for the presence of bone metastasis. No patient presented bone metastasis in scintigraphy if having PSA < 10 ng/mL, and in only 1 patient (0.46 x 0025;) with bone metastasis PSA concentration was < 20 ng/mL. Therefore, when the cutting point adopted for PSA serum concentration was 10 ng/mL, a negative predictive value for bone metastasis was 100 x 0025; with sensitivity rates of 100%. Nevertheless, the positive predictive value and the specificity of the method were, respectively, 24.5 x 0025; and 39.7 x 0025;. When the cutting point of PSA serum concentration was 20 ng/mL, an increment was observed in rates of positive predictive value and specificity (41.5 x 0025; and 73.2 x 0025;), respectively, without substantial changes in negative predictive value (99.2 x 0025;) and sensitivity (97.1 x 0025;) of the method.


CONCLUSIONS
Data of present study allow for the conclusion that PSA serum concentration over 20 ng/mL was a more accurate cutting point than PSA serum concentration over 10 ng/mL to predict the presence of bone metastasis in scintigraphy.
Rhoden
Ernani L
EL
Section of Urology, Federal Foundation Medical School of Porto Alegre, Hospital da Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Torres
Olavo
O
Ramos
Gabriel Z
GZ
Lemos
Rafael R
RR
Souto
Carlos A V
CA