To investigate the relationship between tPSA,fPSA,ALP and Gleason scores and bone metastasis of prostate cancer,and to evaluate the predictive value of combined detection for bone metastasis of prostate cancer.Methods A retrospective analysis of patients with prostatic hyperplasia and prostate cancer(tPSA>10 ng/mL) and healthy subjects in our hospital from January 1,2015 to November 1,2018.Patients with prostate cancer were divided into bone metastasis group and nonbone metastasis group by radionuclide bone imaging.A total of 304 complete cases were collected for analysis, including 48 cases(15.8%) of the prostate cancer with bone metastasis group and 116 cases(38.2%) of the prostate cancer with non-bone metastasis group,56 cases(18.4%) of the benign prostatic hyperplasia group and 84 people(27.6%) of the healthy control group.Results The tPSA and fPSA were significantly different between any two groups(P<0.05).There were significant differences between the bone metastatic group and other three groups of ALP(P<0.05).There was significant difference between the bone metastatic group and non-bone metastasis group of Gleason scores(P<0.05).The bone metastasis rate of prostate cancer patients was lower in lowrisk group than in middle-risk and high-risk group.When the single index tPSA, fPSA and ALP were used to predict the bone metastasis of prostate cancer,the areas under the ROC curve were 0.664,0.700 and 0.783,respectively.The optimal critical diagnostic values were 57.47 ng/mL,8.44 ng/mL and 85.47 U/L,respectively.It was found that the specificity and positive predictive value of the combined detection of the three indicators(tPSA+fPSA+ALP) were 86.20% and 64.40%,higher than single index and combination of two indicators.Conclusions For patients with prostate cancer suspected of having bone metastasis,it is not advisable to use serum PSA concentration alone to judge bone metastasis.The risk of bone metastasis should be predicted by combining tPSA,fPSA,ALP and Gleason score.
