title: Prostate cancer in patients from rural and suburban areas--PSA value, Gleason score and presence of metastases in bone scan.
abstract: BACKGROUND
  Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA) serum value is used both as a screening tool and for staging of prostate cancer.
  
  
  OBJECTIVE
  To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores.
  
  
  METHODS
  A group of 186 patients (aged: 68.38±6.16) diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków.
  
  
  METHODS
  Analysis of all laboratory findings (including PSA value) and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP) labeled with Tc-99m.
  
  
  RESULTS
  In patients with a Gleason value≤7 and a PSA value≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (p<0.01). Correlations were established between PSA value and presence of metastases in bone scan (r=0.45, p=0.05), the number of metastases (r=0.66, p<0.01), and their presence in particular body regions.
  
  
  CONCLUSIONS
  The correlation between PSA value and both presence and number of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA=10 ng/ml.
authors.affiliation: Hygiene and Diet Department, Jagiellonian University Medical College, Cracow, Poland; Nuclear Medicine Department, John Paul II Hospital, Cracow, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Szot
authors.affiliation: Nuclear Medicine Department, John Paul II Hospital, Cracow, Poland; Cardiovascular Diseases Department, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kostkiewicz
authors.affiliation: Hygiene and Diet Department, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Zając
authors.affiliation: Higher School of Public Health, Zielona Góra, Poland.
authors.forename: Alfred
authors.initials: A
authors.lastname: Owoc
authors.affiliation: Department for Health Problems of Ageing, Institute of Rural Health, Lublin, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Bojar
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010147:Pain Measurement; D011044:Poland / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D011877:Radionuclide Imaging
chemical_list: D017430:Prostate-Specific Antigen