18F-FDG PET/CT影像检查与前列腺癌骨转移患者tPSA、fPSA、ALP表达水平的相关性  

Correlation between 18F-FDG PET/CT imaging parameters and expression of tPSA,fPSA and ALP in prostate cancer patients with bone metastases

作　　者：吴凌梅 王庆云[2] 杨晖[3] 魏雁[1] 冀栓猛[2] 王玺植 Wu Lingmei;Wang Qingyun;Yang Hui;Wei Yan;Ji Shuanmeng;Wang Xizhi(Department of Nuclear Medicine,Xingtai People’s Hospital,Xingtai,Hebei 054001,China;Department of CT/MR,Xingtai People’s Hospital,Xingtai,Hebei 054001,China;Department of Nuclear Medicine,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]邢台市人民医院核医学科,河北邢台054001 [2]邢台市人民医院CT/MR科,河北邢台054001 [3]中国人民解放军总医院核医学科,北京100853

出　　处：《中华生物医学工程杂志》2019年第5期631-636,共6页Chinese Journal of Biomedical Engineering

基　　金：邢台市科技计划项目(2018ZC075)。

摘　　要：目的探讨18F-FDG PET/CT影像检查与前列腺癌骨转移患者总前列腺特异抗原(tPSA)、游离前列腺特异抗原(fPSA)、碱性磷酸酶(ALP)表达水平相关性,分析18F-FDG PET/CT影像检查对骨转移的诊断意义。方法选择2010年10月至2018年10月于中国人民解放军总医院泌尿外科住院部行手术确诊的前列腺癌患者120例,经病理档案室收集其癌组织标本。收集所有患者实验室检查指标(tPSA、fPSA、ALP)、18F-FDG PET/CT影像检查指标[最大标准摄取值(SUVmax)、平均SUV、肿瘤代谢体积(MTV)和总病灶糖酵解值(TLG)]、从治疗起2年期间生存、复发及转移例数;分析tPSA、fPSA、ALP与18F-FDG PET/CT影像检查、骨转移临床病理特征相关性,并建立多元回归方程分析骨转移患者死亡高危因素。结果120例前列腺患者经骨扫描确诊骨转移阴性41例,骨转移阳性79例;骨转移组SUVmax、平均SUV、MTV、TLG、tPSA、fPSA、ALP值高于无骨转移组(P<0.05);tPSA、fPSA均与ALP呈显著正相关关系(r=0.320,r=0.416,均P<0.05);骨转移患者2年生存率低于无骨转移患者(56.96%比75.61%,P<0.05);TNM分期Ⅲ/Ⅳ期、有淋巴结转移、tPSA、fPSA、ALP、SUVmax、平均SUV、MTV和TLG值均是骨转移患者死亡危险因素(P<0.05)。结论前列腺癌患者发生骨转移生存率降低,利用血清tPSA、fPSA、ALP联合18F-FDG PET/CT影像检查指标检测可提高前列腺癌患者骨转移诊断准确性,对提高前列腺癌患者预后有较大价值。Objective To investigate the correlation between parameters of 18F-FDG PET/CT and expression levels of total prostate specific antigen(tPSA),free prostate specific antigen(fPSA)and alkaline phosphatase(ALP)in prostate cancer patients with bone metastases.Methods Included in this study were 120 patients with surgically confirmed prostate cancer hospitalized in Department of Urology,Chinese PLA General Hospital,between October 2010 and October 2018.The samples of cancer tissues were collected with assistance of pathologists.All laboratory investigation findings(tPSA,fPSA,and ALP),and the 18F-FDG PET/CT imaging parameters[maximum standardized uptake value(SUVmax),mean SUV,metabolic tumor volume(MTV)and total lesion glycolysis(TLG)],2-year survival,recurrence and metastasis were recorded.The correlation between tPSA,fPSA and ALP,18F-FDG PET/CT imaging and the clinicopathological characteristics of bone metastasis was analyzed.Multiple regression equation was developed to analyze the high risk factors of death in patients with bone metastasis.Results Imaging scan for bone metastasis was negative in 41 cases and positive in 79.Patients with bone metastasis showed higher SUVmax,mean SUV,MTV,TLG,tPSA,fPSA and ALP than those with bone metastasis(P<0.05).tPSA and fPSA were positively correlated with ALP(r=0.320,r=0.416,both P<0.05),and were with lower 2-year survival rate(56.96%vs 75.61%,P<0.05).TNMⅢ/Ⅳstages,lymph node metastasis,SUVmax,mean SUV,MTV,TLG,tPSA,fPSA and ALP were all risk factors for death in patients with bone metastasis(P<0.05).Conclusion Prostate cancer patients with bone metastases face relatively low survival rate.Detection of serum tPSA,fPSA and ALP combined with 18F-FDG PET/CT imaging study may improve the diagnostic accuracy of bone metastasis,and therefore is useful for improving the prognosis of prostate cancer.

关 键 词：PET/CT影像检查 前列腺癌骨转移 总前列腺特异抗原、游离前列腺特异抗原、碱性磷酸酶 相关性 

分 类 号：R730[医药卫生—肿瘤] R737[医药卫生—临床医学]