Clinical-morphological and laboratory predictors of «superscan» scintigraphy phenomenon in prostate cancer
https://doi.org/10.21294/1814-4861-2020-19-2-17-24
Abstract
Introduction. Detection of bone metastases in cancer patients is of great importance in the choice of treatment tactics and assessment of the disease prognosis. The article discusses the «superscan» phenomenon on bone scintigraphy in detecting skeletal metastases in prostate cancer (PC) patients. When analyzing published reports, we found only one large prospective study and a few case report publications on the detection of «superscan» in patients with generalized skeletal involvement.
The purpose of the study was to determine the laboratory and clinical morphological parameters associated with «superscan» scintigraphic phenomenon in patients with prostate cancer.
Material and Methods. Of 2474 prostate cancer patients who underwent bone scintigraphy, 48 had the «superscan» phenomenon. Clinical, laboratory and morphological parameters were: age of the patients, tumor stage by TNM (7th edition, 2010), histological type of the tumor, Gleason index, prostate specific antigen (PSA) level, pain syndrome (on a 5-point verbal scale of pain estimates, 1982), the presence of castration-resistant prostate cancer, hemoglobin level and erythrocyte sedimentation rate (ESR).
Results. The «superscan» phenomen was found to occur most often in prostate cancer patients aged 60-69 years. Stage III and IV tumors were detected in 97.9 % of cases, lymphatic invasion in 20.8 %, and visceral metastases in 12.5 %. In addition, the phenomenon was associated with high PSA levels (the mean PSA level was 100 ng/ml, range: 26-4957) and the presence of moderately and poorly differentiated (Gleason ≥7)) tumors. Chronic pain syndrome at the time of detection of «superscan» was observed in 47.9% of patients, castration resistance - in 16.6 %. The median hemoglobin level was 114 (75-139) g/l and ESR was 34 (14-62) mm/h.
Conclusion. The most significant factors associated with the «superscan» scintigraphy phenomenon in prostate cancer patients were the primary tumor extension, high PSA level and low-grade tumors. New data on the association between the «superscan» phenomenon and the levels of hemoglobin and ESR have been obtained. Further studies on the relationship between the «superscan» phenomenon and pain syndrome and castration resistance are required.
About the Authors
N. Yu. Shumilina
Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky; Krasnoyarsk State Medical university named after Prof. V.F. Voyno-Yasenetsky
Russian Federation
Russian Federation
Natalya Yu. Sluimilina - MD, Head of Radionuclide Diagnostic Department, KrRCOCr named after A.I. Kryzhanovsky.
16, 1-st Smolenskaya str., 660133-Krasnoyarsk; 1, Partizana Zheleznyaka str., 660022-Krasnoyarsk
V. V. Vyazmin
Krasnoyarsk state Medical University named after Prof. V.F. Voyno-Yasenetsky
Russian Federation
Russian Federation
Vadim V. Vyazmin - Resident physician, Department of Oncology and Radiation Therapy with Course of Postgraduate Education, KrSMU named after Professor VF. Voyno-Yasenetsky.
1, Partizana Zheleznyaka str., 660022-Krasnoyarsk
E. Yu. Evdokimova
Krasnoyarsk state Medical university named after Prof. V.F. Voyno-Yasenetsky; Krasnoyarsk Regional Clinical Hospital
Russian Federation
Russian Federation
Elena Yu. Evdokimova - MD, PhD, Associate Professor, Department of Radiation D iagnostics with Course of Postgraduate Education, KrSMU named after Professor V.F. Voyno-Yasenetsky, Researcher ID (WOS): U-7513-2018.
1, Partizana Zheleznyaka str., 660022-Krasnoyarsk; 3a, Partizana Zheleznyaka str., 660022-Krasnoyarsk
D. O. Dashanov
Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky
Russian Federation
Russian Federation
Dmitriy O. Dashanov - MD, oncologist KrRCOCr named after A.I. Kryzhanovsky.
16, 1-st Smolenskaya str., 660133-Krasnoyarsk
N. G. Chanchikova
Center of Nuclear Medicine, Federal siberian Research Clinical Centre
Russian Federation
Russian Federation
Natalya G. Chanchikova - MD, Director of the Center of Nuclear Medicine of the SRCC under FMBA.
16, 1-st Smolenskaya str., 660133-Krasnoyarsk
R. A. Zukov
Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky; Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky
Russian Federation
Russian Federation
Ruslan A. Zukov - MD, PhD, DSc, Head of the Department of Oncology and Radiation Therapy, KrSMU named after Prof. V.F. Voyno-Yasenetsky.
16, 1-st Smolenskaya str., 660133-Krasnoyarsk; 1, Partizana Zheleznyaka str., 660022-Krasnoyarsk
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For citations:
Shumilina N.Yu., Vyazmin V.V., Evdokimova E.Yu., Dashanov D.O., Chanchikova N.G., Zukov R.A. Clinical-morphological and laboratory predictors of «superscan» scintigraphy phenomenon in prostate cancer. Siberian journal of oncology. 2020;19(2):17-24. (In Russ.) https://doi.org/10.21294/1814-4861-2020-19-2-17-24
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