【摘要】 目的　探讨骨肉瘤患者治疗前SAP(serumalkalinephosphatase)值升高对患者预后的临床意义。方法　对 1 1 7例骨肉瘤患者 ( 1 9例在就诊时发现转移 ,98例未发现转移 )治疗前SAP值水平的测定 ,并进行统计学分析。结果　 ( 1 )就诊时已经发生转移的患者中 ,SAP值显著升高的人数明显高于就诊时没有发生转移的SAP值显著升高的人数 ( 68 4%和 3 6 7% ;P <0 0 5 ) ,( 2 )经过治疗后 ,就诊时没有发生转移的患者中 ,SAP值水平增高的患者再次发生转移和复发的比例明显高于SAP值水平正常的患者 ( 3 3 8%和 1 1 1 % ;P <0 0 5 ) ,( 3 )就诊时SAP值水平高的患者中 ,其治疗后转移复发率高于SAP值水平正常的患者 ( 3 9%和1 3 3 % ;P <0 0 1 ) ,而且 ,治疗前SAP值越高 ,即使通过正规的治疗 ,其治疗后转移、复发率也越高 (≤ 1 9岁 ,P<0 0 1 ;≥ 2 0岁 ,P <0 0 5 )。 ( 4 )大部分患者经过治疗后 (包括化疗、术前化疗和手术 ) ,SAP值有下降和恢复正常的趋势 ,并且化疗前后和手术前后SAP值有显著的统计学意 (P≤ 0 0 0 1 )。但是 ,手术后SAP值水平与肿瘤的转移、复发率没有明显的相关性 (P =0 42 2 )。结论　通过这些数据可以证明 :对于骨肉瘤患者来说 ,治疗前SAP值水平与患者的预后有相关性 ,对骨肉瘤患者治疗前S更多还原

【Abstract】 Objective To study clinical prognostic significance of serum alkaline phosphatase (SAP) levels before treatment in patients with osteosarcoma.. Methods The SAP levels before treatment in 117 patients with osteosarcoma (metastasic tumor to be found in 98 and localized tumor without metastasis to be seen in 19 when patients came to seek medical aid) were examined and analyzed with statistics. Results Firstly,the percentage of patients with considerably elevated SAP levels was significantly higher in the metastasic group than that in localized group (68.4% versus 36.7%;P<0.05).Secondly,in the localized group after treated with adjuvant or neoadjuvant chemotherapy and surgery,the recurrence rate was significantly higher in patients with elevated SAP levels before treatment than in those with normal levels (33.8% versus 11.1%;P<0.05).Thirdly,the recurrence rate after treatment in patients with elevated SAP levels before treatment was significantly higher than that in patients with normal SAP levels before treatment.Moreover,the higher the elevated SAP levels before treatment went up,the higher the metastasic rate and recurrence rate appeared after treatment,no matter how routine treatment they received (≤19 years old,P<0.01;≥20 years old,P<0.05).Lastly,the SAP levels after treatment of the most patients almost always return to normal values(P≤0.001),but a correlation between postoperative levels of the enzyme and prognosis could not be seen (P=0.422).Conclusion These data demonstrate that the SAP levels before treatment in patients with osteosarcoma have a prognostic value.These values of SAP can help us to adjust the protocol of chemotherapy rationally,not only reaching the goal of individual treatment,but also elevating long term survival rate of the patients.更多还原