PSMA-SPECT/CT在前列腺癌转移灶检测中的应用价值  被引量:7

The value of PSMA-SPECT/CT in the diagnosis of metastatic lesions in patients with prostate cancer

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作  者:宿恒川[1] 朱耀[1] 胡四龙[2] 许晓平[2] 程竞仪[2] 万方宁[1] 叶定伟[1] 

机构地区:[1]复旦大学附属肿瘤医院泌尿外科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院核医学科,上海200032

出  处:《现代泌尿外科杂志》2016年第10期748-750,共3页Journal of Modern Urology

基  金:上海市青年科技启明星计划基金(No.16QA1401100)

摘  要:目的 进一步提高前列腺癌转移灶的诊断水平。方法 收集2015~2016年我院收治并接受前列腺特异性膜抗原(PSMA)-单光子发射计算机断层摄影术联合同机CT扫描图像融合技术(SPECT/CT)检查的前列腺癌患者,对其中3例典型患者的临床资料进行回顾性分析。结果 2例前列腺癌患者行前列腺癌根治术后,前列腺特异性抗原(PSA)水平未达到理想水平,MRI、CT以及骨扫描未能显示病灶,而PSMA-SPECT/CT可探测出这2例患者可疑转移淋巴结,1例位于右髂总血管旁,另1例位于左髂总血管旁及腹膜后淋巴结。1例并发膀胱癌的前列腺癌患者,左侧髂血管旁淋巴结肿大,病理来源不明,结合膀胱癌病理结果以及PSMA-SPECT/CT检查结果,推测髂血管旁淋巴结来源于前列腺癌可能性大,术后病理证实髂血管淋巴结转移来源于前列腺癌。结论 本研究提示PSMA-SPECT/CT较现有影像学检查如MRI、骨扫描、CT等,可在PSA较低水平发现可疑前列腺癌转移灶。对于多器官肿瘤患者而言,若出现淋巴转移,PSMA-SPECT/CT可帮助判定淋巴转移病灶来源,从而指导临床治疗。Objective To improve the diagnosis for metastatic lesions in patients with prostate cancer. Methods The clinical data of 3 typical cases of prostate cancer treated during 2015 and 2016 who received PSMA-SPECT/CT were analyzed. Results The prostate specific antigen (PSA) control in 2 cases was not satisfactory after radical prostatectomy. MRI, CT and bone scan found no metastatic lesions while PSMA-SPECT/CT showed suspicious lymph node metastases, 1 case in sites near the right iliac blood vessels and the other in sites near the left iliac blood vessels and retroperitoneal lesions. One case who was accompanied with bladder cancer presented with lymph nodes enlargement near iliac blood vessels and thus the origin of metastatic lesions was uncertain. According to the histologic examination and PSMA-SPECT/CT, the metastatic lesions were speculated to originate from prostate cancer and the postoperative pathological examination confirmed the speculation. Conclusion Compared to currently commonly used imaging examination,PSMA-SPECT/CT can detect metastatic lesions of patients with prostate cancer more efficiently, even at low levels of PSA. For patients with malignant tumors of multiple organs, PSMA-SPECT/CT can help to ensure the origin of the metastatic lesions when these patients present with lymph nodes enlargement.

关 键 词:前列腺特异性膜抗原 单光子发射计算机断层摄影术联合同机CT扫描图像融合技术 前列腺癌 转移灶 

分 类 号:R737[医药卫生—肿瘤]

 

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