68Ga-PSMA-617 PET/CT对高危前列腺癌的预测价值  

Predictive value of 68Ga-PSMA PET/CT for high-risk prostate cancer

作　　者：刘辰[1] 刘特立 杨志[1] 张宁[2] 杜鹏[2] 杨勇[2] 刘毅强[3] 王静 严昆[5] 杨兴 朱华[1] 李囡[1] Liu Chen;Liu Teli;Yang Zhi;Zhang Ning;Du Peng;Yang Yong;Liu Yiqiang;Wang Jing;Yan Kun;Yang Xing;Zhu Hua;Li Nan(Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing),Department of Nuclear Medicine,Peking University Cancer Hospital & Institute,Beijing 100142,China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing ),Department of Urology,Peking University Cancer Hospital & Institute,Beijing 100142,China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing),Department of Pathology,Peking University Cancer Hospital &Institute,Beijing 100142,China;Department of Medical Science,Peking University Health Science Center,Beijing 100191,China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing),Department of Ultrasonography,Peking University Cancer Hospital & Institute,Beijing 100142,China;Department of Nuclear Medicine,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科、恶性肿瘤发病机制及转化研究教育部重点实验室,100142 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所泌尿外科、恶性肿瘤发病机制及转化研究教育部重点实验室,100142 [3]北京大学肿瘤医院暨北京市肿瘤防治研究所病理科、恶性肿瘤发病机制及转化研究教育部重点实验室,100142 [4]北京大学医学部医用理学系,100191 [5]北京大学肿瘤医院暨北京市肿瘤防治研究所超声科、恶性肿瘤发病机制及转化研究教育部重点实验室,100142 [6]北京大学第一医院核医学科,100034

出　　处：《中华核医学与分子影像杂志》2019年第2期77-80,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：北京大学医学科技创新平台发展基金-医学交叉种子基金(BMU2018MX007).

摘　　要：目的 探讨68Ga-前列腺特异膜抗原(PSMA)-617 PET/CT对高危前列腺癌的预测价值。 方法 回顾性分析2016年5月至2017年1月间30例(中位年龄67岁)经穿刺活组织检查证实的前列腺癌患者的68Ga-PSMA-617 PET/CT及临床资料,依据美国国立综合癌症网络(NCCN)指南的前列腺癌危险度分级标准[Gleason评分、前列腺特异抗原(PSA)水平]将患者分为低~中危组和高危组。半定量分析患者PET图像获得前列腺癌最大标准摄取值(SUVmax),基于SUVmax建立高危前列腺癌的logistic回归预测模型,采用受试者工作特征(ROC)曲线分析评价其诊断效能。 结果 30例患者中位Gleason评分为7.5(7,9)分;中位PSA水平为34.0(19.4,119.1) μg/L,其中PSA≤20 μg/L者9例,PSA>20 μg/L者21例。根据NCCN指南,24例为高危前列腺癌,6例为低~中危前列腺癌。高危组的SUVmax明显高于低~中危组[14.2(11.4, 23.1)与7.9(3.8, 13.1);u=118,P<0.05]。以SUVmax建立的二分类logistic回归模型预测高危前列腺癌的ROC曲线下面积为0.819。以预测概率0.73为截断值,预测模型的诊断灵敏度及特异性分别为87.5%(21/24)和4/6。 结论 68Ga-PSMA-617 PET/CT显像的SUVmax可作为独立预测高危前列腺癌的影像学参考指标。Objective To investigate the value of 68Ga-prostate specific membrane antigen (PSMA)-617 PET/CT in predicting high-risk prostate cancer.Methods From May 2016 to January 2017, 30 patients (median age 67 years) with biopsy-proven prostate cancer were included. The 68Ga-PSMA-617 PET/CT images and clinical data of all patients were analyzed retrospectively. According to prostate cancer risk stratification criteria of National Comprehensive Cancer Network (NCCN) Guidelines (including Gleason scores, prostate specific antigen (PSA)), all patients were classified into low-moderate-risk group and high-risk group. PET images were analyzed semi-quantitatively and maximum standardized uptake value (SUVmax) of primary prostate cancer was measured. SUVmax of 68Ga-PSMA-617 PET/CT was used to establish logistic regression model for predicting high-risk prostate cancer, and the diagnostic efficiency of the model was evaluated by receiver operating characteristic (ROC) curve analysis.Results The median Gleason score of 30 patients was 7.5 (7, 9), and the median PSA was 34.0 (19.4, 119.1) μg/L, including 9 patients with PSA≤20 μg/L and 21 patients with PSA>20 μg/L. According to the NCCN Guidelines, there were 24 patients with high-risk prostate cancer and 6 patients with low-moderate-risk prostate cancer. SUVmax was higher in high-risk group than that in low-moderate-risk group (14.2(11.4, 23.1) vs 7.9(3.8, 13.1);u=118, P<0.05). Logistic regression model established with SUVmax could effectively predict high-risk prostate cancer with the area under ROC curve of 0.819. When the cut-off value was set as 0.73, the sensitivity and specificity of the model were 87.5%(21/24) and 4/6 respectively.Conclusion SUVmax of 68Ga-PSMA-617 PET/CT can be used as an imaging biomarker for predicting high-risk prostate cancer.

关 键 词：前列腺肿瘤 前列腺特异膜抗原 同位素标记 镓放射性同位素 正电子发射断层显 像术 体层摄影术 X线计算机 

分 类 号：R737.25[医药卫生—肿瘤] R730.44[医药卫生—临床医学]