Early detection of bone metastasis with measurement of serum PSA, ALP levels and scintigraphic imaging in patients with prostatic carcinoma

Objective: To explore the most effective diagnostic approach for early detection of bone metastasis in patients with prostatic carcinoma. Methods: Serum PSA (with CLIA) and ALP (with enzyme immunoassay) were determined in 38 patients with prostatic carcinoma and 45 controls (with benign prostatic hyperplasia, BPH). 99mTc bone scanning with SPECT was performed in all the patients with prostatic cancer. Results: Serum PSA and ALP levels in the prostatic cancer patients with bone metastasis (n=22) were significantly higher than those in cancer patients without bone metastasis and controls. Serum PSA levels in both groups of the cancer patients were significantly higher than those in controls (P<0.001). However, serum ALP levels was only significantly higher in cancer patients with bone metastasis (P<0.001) but not so in patients without bone metastasis (P>0.05). Conclusion: In prostatic cancer patients with abnormal ECT findings, simultaneous determination of serum PSA and ALP levels would be helpful for verification of diagnosis. (authors)