Abstract:

Objective To explore the role of age，total prostate specific antigen（tPSA），free prostate specific antigen（fPSA）and Gleason scores in the diagnosis of systemic bone metastasis of prostate cancer（PCa）， and to compare the diagnostic value of MRI and bone scintigraphy in pelvic area bone metastasis to provide refer⁃ ence for early diagnosis of bone metastasis. Methods A total of 51 patients with PCa were selected. The results of bone metastases were determined by the clinical criteria of bone metastases lesions. The related factors of whole body bone metastasis were analyzed，and the diagnosis value of pelvic area bone metastasis with MRI and bone scintigraphy were compared. Results （1）Fifty⁃one PCa patients were divided into bone metastasis group（n = 24） and non⁃bone metastasis group（n = 27）. The tPSA，fPSA，and Gleason scores of bone metastasis group were sig⁃ nificantly higher than those of non⁃bone metastasis group（P < 0.05）. When the cut⁃off values of tPSA and fPSA were 68.59 ng/mL and 6.42 ng/mL，the sensitivity and specificity of diagnosing bone metastasis were the best （75.00% ，81.50% and 83.30% ，81.50% ，respectively）.（2）According to pelvic area analysis，patients were divided into bone metastasis group（n = 22）and non⁃bone metastasis group（n = 29 ）. The sensitivity，specificity and accuracy of MRI，bone scintigraphy and their combined diagnosis of bone metastasis were 86.36%，93.10%， 90.20%（P < 0.05）and 90.91%，86.21%，88.24%（P < 0.05）and 95.45%，79.31%，86.27%（P < 0.05），respec⁃ tively. Conclusion （1）The tPSA，fPSA and Gleason scores are risk factors for definitive PCa systemic bone me⁃tastasis. Increased values are a good indication of predicting bone metastasis，especially when the cut⁃off value of tPSA and fPSA are 68.59 ng/mL and 6.42 ng/mL respectively，the diagnosis is the best.（2）The study of the pelvic area found that MRI has the highest specificity for diagnosing PCa bone metastasis，and the highest sensitivity when combined with bone scintigraphy，indicating that the combination of the two can achieve complementary advantages and contribute to the early diagnosis of PCa bone metastasis. 

Key words:

prostate cancer, prostate specific antigen, gleason scores, bone metastasis, bone scin? tigraphy, magnetic resonance imaging