^18F-PSMA-1007 PET/CT对低PSA水平前列腺癌复发的检测价值  

Detection value of ^18F-PSMA-1007 PET/CT in the recurrence of prostate cancer at low serum prostate specific antigen level

作　　者：田蓉蓉[1] 赵铭[1] 周洁[1] 薄云峰[2] 张红雨 郝海龙[3] 原凌[1] 邢军[1] Tian Rongrong;Zhao Ming;Zhou Jie;Bo Yunfen;Zhang Hongyu;Hao Hailong;Yuan Ling;Xing Jun(Department of PET/CT Center,Shanxi Tumor Hospital,Taiyuan 030013,China;Department of Pathology,Shanxi Tumor Hospital,Taiyuan 030013,China;Department of Urology,Shanxi Tumor Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院PET/CT中心,太原030013 [2]山西省肿瘤医院病理科,太原030013 [3]山西省肿瘤医院泌尿外科,太原030013

出　　处：《中华核医学与分子影像杂志》2020年第10期589-594,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：山西省重点研发计划项目(201903D321187)。

摘　　要：目的探讨^18F-前列腺特异膜抗原(PSMA)-1007 PET/CT对低前列腺特异抗原(PSA)水平前列腺癌复发的检测价值。方法回顾性分析2018年7月至2019年6月在山西省肿瘤医院行^18F-PSMA-1007 PET/CT显像的可疑生化复发的低PSA水平(<2.0μg/L)前列腺癌患者45例(年龄59~74岁)。PSA<0.2μg/L者4例(因例数较少未纳入统计分析),0.2μg/L≤PSA<2.0μg/L者41例。41例中,0.2μg/L≤PSA<0.5μg/L 10例,0.5μg/L≤PSA<1.0μg/L 14例,1.0μg/L≤PSA<2.0μg/L 17例。检测血清PSA水平2周内对患者行PET/CT检查,并依据美国国立综合癌症网络(NCCN)指南将其分为低~中危组(n=12)和高危组(n=29)。采用χ^2检验、Fisher确切概率法和Spearman秩相关分析数据。结果中位随访7(4~15)个月,45例患者经病理或随访证实,复发31例,未复发14例。^18F-PSMA-1007 PET/CT诊断前列腺癌复发的灵敏度为100%(31/31),特异性为13/14,准确性为97.78%(44/45)。1例PSA<0.2μg/L患者出现腹膜后淋巴结转移,41例0.2μg/L≤PSA<2.0μg/L患者中,31例(75.61%)PET/CT显像至少有1处前列腺癌复发灶,其中局部复发20例,淋巴结转移13例,骨转移14例;PSA水平在0.2μg/L≤PSA<0.5μg/L、0.5μg/L≤PSA<1.0μg/L、1.0μg/L≤PSA<2.0μg/L时复发灶检出率分别为5/10、11/14和15/17,但组间比较差异无统计学意义(χ^2=4.641,P>0.05)。^18F-PSMA-1007 PET/CT阳性结果与血清PSA值、危险度分组呈正相关(r值:0.394和0.384,均P<0.05)。结论^18F-PSMA-1007 PET/CT对于低PSA水平的前列腺癌生化复发灶有较高的检测价值。Objective To investigate the value of ^18F-prostate specific membrane antigen(PSMA)-1007 PET/CT in the detection of prostate cancer recurrence at low serum prostate specific antigen(PSA)level.Methods From July 2018 to June 2019,45 patients(age:59-74 years)with suspected biochemical recurrence of prostate cancer with low PSA level(<2.0μg/L)who underwent ^18F-PSMA-1007 PET/CT examinations in Shanxi Tumor Hospital were retrospectively analyzed.Four patients with PSA<0.2μg/L were not included in the statistical analysis due to the small sample.Among the remaining 41 patients with 0.2μg/L≤PSA<2.0μg/L,10 were with 0.2μg/L≤PSA<0.5μg/L,14 were with 0.5μg/L≤PSA<1.0μg/L,17 were with 1.0μg/L≤PSA<2.0μg/L.PET/CT imaging were performed within 2 weeks after the examination of serum PSA.All patients were divided into low-moderate-risk group(n=12)and high-risk group(n=29)according to the National Comprehensive Cancer Network(NCCN)guidelines.χ^2 test,Fisher′s exact test and Spearman rank correlation were used to analyze the data.Results Patients were followed up for 7(4-15)months,and all 45 patients were confirmed by pathology or follow-up.There were 31 patients with recurrence and 14 patients without recurrence.The sensitivity,specificity and accuracy were 100%(31/31),13/14,97.78%(44/45)respectively.One patient with PSA<0.2μg/L presented retroperitoneal lymph node metastasis.Among 41 patients with 0.2μg/L≤PSA<2.0μg/L,31(75.61%)were with at least one recurrent lesion by ^18F-PSMA-1007 PET/CT.There were 20 cases of local recurrence,13 cases of lymph node metastasis,14 cases of bone metastasis.The detection efficacies of ^18F-PSMA-1007 PET/CT were 5/10 for patients with 0.2μg/L≤PSA<0.5μg/L,11/14 for those with 0.5μg/L≤PSA<1.0μg/L,and 15/17 for those with 1.0μg/L≤PSA<2.0μg/L(χ^2=4.641,P>0.05).The positive results of ^18F-PSMA-1007 PET/CT were positively correlated with serum PSA value and risk group(r values:0.394,0.384,both P<0.05).Conclusion ^18F-PSMA-1007 PET/CT is a valuable tool for detecti

关 键 词：前列腺肿瘤 复发 前列腺特异抗原 前列腺特异膜抗原 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]