前列腺癌患者血清PSA与磁共振波谱代谢改变的相关性研究  

The Study of Correlation of Serum PSA with Metabolic Changes of Prostate Cancer by ^1H-MRSI

作　　者：李飒英[1] 陈敏[1] 周诚[1] 陈锴[2] 

机构地区：[1]卫生部北京医院放射科,北京100730 [2]吉林大学第一医院放射科,长春130021

出　　处：《临床放射学杂志》2006年第9期855-857,共3页Journal of Clinical Radiology

摘　　要：目的 探讨前列腺癌患者血清前列腺特异抗原（PSA）与磁共振波谱成像（MRSI）所提供的代谢改变程度和范围的相关性。资料与方法 将87例经活检证实为前列腺癌的患者按照MRI／MRSI检查时的PSA水平分为：1组，PSA≤10ng／ml（40例）；2组，10ng／ml〈PSA≤20ng／ml（34例）；3组，PSA〉20ng／ml（13例）。肿瘤存在的可能性按1～5评分，从1～5分依次为：肯定健康，可能健康，不确定，可能癌，肯定癌。确定每例患者周围带内所有有用体素的分数。为了评估PSA与前列腺癌代谢异常的相关性，确定：（1）平均总健康指数；（2）侵犯力指数；（3）空间范围指数。结果 PSA随着年龄的增长而升高（r=0．29，P=0．007），但与肿瘤的体积无关。3组患者之间的MRI／MRSI总健康指数，侵犯力的指数和空间范围指数有明显差异（P=0．02，P=0．04，和P=0．006）。在这3个PSA组之间，每个MRSI指数都与PSA成正相关（r=0．25，P=0．02；r=0．23，P=0．03；和r=0．3，P=0．005）。然而，在每一个PSA组内，PSA与任何一个MRSI指数都没有明显的关联性。结论 血清PSA结合MRSI所提供的解剖和代谢的信息能够有意义地提高对每一例患者前列腺癌特性的评估。当增加胆碱／肌酐的比值以及枸橼酸盐／正常枸橼酸盐的比值作为选择性诊断标准时，MRSI评价前列腺癌侵犯力方面的作用更加突出。Objective To evaluate prostate cancer by IH Magnetic Resonance Spectroscopic Imaging （3D MRSI）, and to investigate whether a correlation exists between PSA and the magnitude and spatial extent of metabolic changes of prostate cancer provided by MRSI. Materials and Methods 87 cases with biopsy proved prostate cancer was assigned by PSA at the time of MRI/MRSI examination as having： group 1, PSA≤10ng/ml （40 patients）; group 2, 10ng/ml 〈 PSA≤20ng/ml （34 patients）; and group 3, PSA 〉 20ng/ml （ 13 patlents） . The likelihood of tumor presence was encoded using a 5 point rating scale, which represents healthy, possible healthy, equivocal, possible cancer, and cancer respectively. In order to get the correlation of PSA with the spatial extent and aggressiveness of prostate cancer, （1） Mean Overall Health; （2） Aggressiveness Index, and （3） Spatial Extent Index were determined. Results There was a significant increase in PSA with increasing age （ r = 0.29, P = 0.007）, no correlation with gland volume. The MRSI indices of health, aggressiveness and spatial extent were significanfly different among the 3 PSA groups （ P = 0.02, P = 0.04, and P = 0.006 respectively）. There was a significant positive correlation between each MRSI index with increasing PSA （ r = 0.25, P = 0.02 ; r = 0.23, P = 0.03 ; and r = 0.3, P = 0. 005 respectively）. However, there was no significant correlation of PSA with the magnitude or extent of cancer as measured by MRI/MRSI in each group. Conclusion Combined with PSA and the magnitude and spatial extent of metabolic changes of prostate cancer provided by MRSI has significant value in evaluating the aggressiveness of prostate cancer, and this value is heightened by adding the Choline/Creatine ratio （Cho/Cr） and the Citrate/Normal Citrate ratio （Cit/nom Cit） as one of altemative diagnostic criteria.

关 键 词：磁共振波谱成像 前列腺癌 前列腺特异抗原 

分 类 号：R737.25[医药卫生—肿瘤]