^(18)F-PSMA PET/CT检查对前列腺癌根治术中盆腔淋巴结清扫的影响  

Effects of ^(18)F-PSMA PET/CT on pelvic lymph node dissection in radical prostatectomy:a single-center retrospective study

作　　者：董小鑫 贺大林[1] 樊俊杰 蒋璋栋 王卓楠 谢宏俊[1] 段小艺[3] 李磊[1] 吴开杰[1] DONG Xiaoxin;HE Dalin;FAN Junjie;JIANG Zhangdong;WANG Zhuonan;XIE Hongjun;DUAN Xiaoyi;LI Lei;WU Kaijie(Department of Urology First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Urology,Xi’an 9^(th)Hospital,Xi’an 710061,China;PET-CT Unit,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泌尿外科,陕西西安710061 [2]西安市第九医院泌尿外科,陕西西安710054 [3]西安交通大学第一附属医院PET-CT室,陕西西安710061

出　　处：《现代泌尿外科杂志》2022年第3期234-237,共4页Journal of Modern Urology

基　　金：西安交通大学第一附属医院重大新医疗新技术(No.2019)。

摘　　要：目的探讨术前行^(18)F-PSMAPET/CT检查对前列腺癌根治术中行盆腔淋巴结清扫(PLND)的影响。方法回顾性分析西安交通大学第一附属医院2016年1月至2020年12月接受机器人辅助腹腔镜前列腺癌根治术的744例患者的临床及病理资料,分析开展^(18)F-PSMAPET/CT新技术前后及检查结果对根治术中行PLND与否及术后淋巴结病理阳性率的影响。结果744例前列腺癌患者中在我院开展^(18)F-PSMAPET/CT技术前后行根治术者分别有366例、378例,其中术中行PLND者分别为109例(29.8%)、142例(37.6%),两组差异有统计学意义(P=0.025)。在开展^(18)F-PSMAPET/CT技术后行根治术的378例患者中289例未选择行该项检查,其中88例(30.4%)术中行PLND;选择行该项检查的89例患者中有54例(60.7%)术中行PLND,清扫率显著高于未行检查组(P<0.001)。最后,该项检查提示盆腔淋巴结阳性患者的淋巴结清扫率和术后淋巴结病理阳性率显著高于阴性患者(94.2%vs.52.8%,P=0.002)和(43.7%vs.0%,P=0.001)。结论^(18)F-PSMAPET/CT的临床应用有助于改善前列腺癌的精准分期,特别是对潜在转移性盆腔淋巴结的发现,会增加根治术中行PLND的比例及术后病理阳性率。Objective To explore the effects of preoperative ^(18)F-PSMA PET/CT on pelvic lymph node dissection(PLND)in radical prostatectomy.Methods The clinicopathological data of 744 patients with prostate cancer who underwent radical prostatectomy during Jan.2016 and Dec.2020 were reviewed.The rate of PLND after ^(18)F-PSMA PET/CT in patients with posi⁃tive lymph node imaging was analyzed.Results Robot-assisted laparoscopic radical prostatectomy(RARP)before ^(18)F-PSMA PET/CT was performed in 366 cases,including 109(29.8%)who underwent PLND,while RARP after ^(18)F-PSMA PET/CT was performed in 378 cases,including 142(37.6%)who underwent PLND(P=0.025).Altogether 289 patients did not select^(18)F-PSMA PET/CT examination after performance of this technique,and 88(30.4%)of whom underwent PLND,while 54 of the 89 patients(60.7%) with ^(18)F-PSMA PET/CT examination underwent PLND(P<0.001).Higher rate of PLND(94.2%vs.52.8%,P=0.02)and postoperative lymph node metastasis(43.7%vs.0%,P=0.001)were observed in patients with posi⁃tive lymph node imaging in ^(18)F-PSMA PET/CT compared to patients with negative lymph node imaging.Conclusion Clini⁃cal application of ^(18)F-PSMA PET/CT helps to improve the accurate staging of prostate cancer,particularly for the discovery of potentially metastatic pelvic lymph nodes.It can also change the rate of PLND in radical prostatectomy and postoperative patho⁃logical lymph node metastasis,especially in patients with a positive lymph node imaging.

关 键 词：^(18)F-PSMAPET/CT 前列腺癌 根治术 盆腔淋巴结清扫术 

分 类 号：R737.25[医药卫生—肿瘤]