^(18)F-PSMA-1007 PET/CT全身肿瘤负荷预测前列腺癌血清PSA进展的价值  

The value of ^(18)F-PSMA PET/CT whole body tumor burden in predicting the serum PSA progression in prostate cancer

作　　者：李运轩 郑安琪 沈聪 王卓楠 高俊刚[1] 刘翔[1] 李阳[1] 段小艺[1] LI Yunxuan;ZHENG Anqi;SHEN Cong;WANG Zhuonan;Gao Jungang;LIU Xiang;LI Yang;DUAN Xiaoyi(PET‒CT Center,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院PET-CT室,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2022年第2期186-190,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：西安交通大学第一附属医院临床研究项目(No.XJTU1AF-CRF-2020-008);西安交通大学第一附属医院新医疗新技术项目(No.XJYFY-2019J1)。

摘　　要：目的分析^(18)F-PSMA PET/CT全身肿瘤负荷与前列腺特异性抗原(PSA)及Gleason评分的相关性,评估全身肿瘤负荷预测前列腺癌血清PSA进展的价值。方法回顾性收集2019年3月至2021年4月行^(18)F-PSMA-1007PET/CT检查的前列腺癌患者213例,通过半自动方法计算全身肿瘤负荷,分析其与血清PSA及Gleason评分的相关性。根治术后患者根据^(18)F-PSMA PET/CT结果分为阳性组及阴性组,比较组间PSA的差异,绘制受试者工作特征曲线(ROC),得出PSA预测^(18)F-PSMA PET/CT阳性率的阈值。对根治术后患者进行PSA随访,根据PSA进展情况分组,比较组间肿瘤负荷的差异。结果在Gleason评分≤7分、=8分及≥9分三组中,每组肿瘤负荷均与PSA有相关性(P=0.001),组间差异有统计学意义(P<0.001)。初诊初治组、生化复发组、药物治疗组中,全身肿瘤负荷与PSA存在相关性(P=0.001)。原发灶Gleason评分与全身肿瘤负荷亦存在相关性(P<0.001)。根治术后PSA水平预测^(18)F-PSMA PET/CT检测阳性率的ROC曲线下面积为0.821,当PSA>0.577 ng/mL时,敏感度和特异度分别为66.7%和96.8%。^(18)F-PSMA PET/CT阳性者中出现PSA进展的患者全身肿瘤负荷平均值高于无PSA进展者。结论同时PSA也能一定程度预测^(18)F-PSMA PET/CT阳性结果,这将指导临床合理选择此检查。Objective To analyze the correlation of whole body tumor burden of^(18)F-prostate specific membrane antigen positron emission computed tomography(^(18)F-PSMA PET/CT)with prostate specific antigen(PSA)and Gleason score so as to evaluate the value of^(18)F-PSMA PET/CT whole body tumor burden for predicting serum PSA progression in prostate cancer.Methods We retrospectively recruited 213 patients with prostate cancer who underwent^(18)F-PSMA PET/CT scanning from March 2019 to April 2021.The serum PSA and Gleason score were collected.Whole body tumor burden was measured by a semi-automatic method.The correlation of tumor burden with serum PSA and Gleason score was analyzed.After radical prostatectomy,the patients were divided into groups according to negative or positive^(18)FPSMA PET/CT.PSA differences between groups were compared,and the receiver operating characteristic curve(ROC)of the subjects was drawn so as to obtain the threshold value of PSA to predict the positive rate of^(18)F-PSMA PET/CT.The patients were followed up for PSA after radical surgery,divided into groups according to the progress of PSA,and the differences in tumor burden between groups were compared.Results In Gleason score≤7,=8,and≥9 groups,whole body tumor burden was correlated with PSA in each group(P=0.001),and tumor burden significantly differed between the groups(P<0.001).In initial diagnosis and treatment group,biochemical recurrence group,and medication group,the correlation between tumor burden and PSA was statistically significant(P=0.001).The Gleason score of primary prostate lesion was significantly correlated with systemic tumor burden(P<0.001).The area under ROC curve of PSA predicting the positive rate of^(18)F-PSMA PET/CT after radical prostatectomy was 0.821;when PSA>0.577 ng/mL,the sensitivity and the specificity were 66.7%and 96.8%,respectively.The mean whole body tumor burden in^(18)F-PSMA PET/CT positive patients with PSA progression was higher than that in patients without PSA progression.Conclusion The whole body tu

关 键 词：前列腺癌 前列腺特异性膜抗原 正电子发射计算机断层扫描 全身肿瘤负荷 血清PSA进展预测 

分 类 号：R737.25[医药卫生—肿瘤]