Klin Onkol 2000; 13(4): 122-121.
Summary: Background: To evaluate the ability of serum PSA, ALP, tumor grade and local clinical stage to predict hone metastases. Design and subjects: We analysed above mentioned parameters in 119 meD with newly diagnosed prostate cancer (NPV) for different cut-off point values and performed also ROC curves to predict a positive hone scan. Methods and results: We found a significant difference between PSA level in 75 patients without metastases and 44 patients with metastases (11.4 vs 94.4 ng/ml). Only ODe patient with PSA under 10 ng/ml had a positive hone scan. All patients with elevated ALP had a positive hone scan. 43 patients with metastases had locally advanced moderately or poor differentiated prostate cancer. This resulted in the sensitivity 98% and NPV 97% for PSA at a treshold of 10 ng/ml, the specificity 100% and PPV 100% for ALP at a treshold of 2,6 ~at/l, the sensitivity 98% and NPV 96% for moderately or poor differentiated prostate cancer, with the almost same results for locally advanced prostate cancer. Using ROC curves, however, PSA had the best ability to predict hone metastases. Conclusions: In consideration of our results we don't recornmend hone scintigraphy as a routine part of an initial evaluation in patients with serum PSA under 10 ng/ml, normallevel of ALP, well differentiated and localized prostate cancer
