^(18)F-PSMA-1007PET/CT在低tPSA水平前列腺癌中的应用价值  

The application value of ^(18)F-PSMA-1007 PET/CT in prostate cancer with low tPSA level

作　　者：郑安琪 王卓楠 沈聪 董伟璇 白璐[1] 吴开杰[2] 段小艺[1] ZHENG Anqi;WANG Zhuonan;SHEN Cong;DONG Weixuan;BAI Lu;WU Kaijie;DUAN Xiaoyi(PET-CT Center,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Urology,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 [2]西安交通大学第一附属医院泌尿外科,陕西西安710061

出　　处：《实用放射学杂志》2022年第6期936-939,共4页Journal of Practical Radiology

基　　金：西安交通大学第一附属医院新医疗新技术项目(XJYFY-2019J1);西安交通大学第一附属医院临床研究项目(XJTU1AFCRF-2020-008)。

摘　　要：目的 探讨^(18)F-前列腺特异性膜抗原(PSMA)-1007 PET/CT诊断低血清总前列腺特异性抗原(tPSA)水平前列腺癌与早期生化复发中的应用价值.方法 回顾性收集因前列腺病变行^(18)F-PSMA-1007 PET/CT患者的临床资料,分为未经治疗的初诊组(tPSA 4.0~20 ng/mL)和根治性前列腺切除(RP)术后的生化复发组(tPSA 0.2~10 ng/mL).初诊组以病理结果为金标准,分析诊断效能,绘制受试者工作特征(ROC)曲线;生化复发组以PET/CT结合其他临床资料判断有无复发灶,获得诊断效能.结果 初诊组39例怀疑前列腺癌的患者中,PET/CT阳性34例,其中1例为假阳性,肿瘤检出率为84.6%(33/39).曲线下面积(AUC)为0.846,灵敏度、特异度、准确性、阳性预测值、阴性预测值分别为94.3%、75.0%、92.3%、97.1%、60.0%.33例真阳性病例中,PET/CT检出盆腔淋巴结转移5例,盆腔外淋巴结转移3例,骨转移9例,肺转移1例.44例生化复发者中,PET/CT阳性22例,阳性检出率为50.0%,灵敏度、特异度、准确性、阳性预测值和阴性预测值分别为50.0%、80.0%、59.4%、84.6%和42.1%;PET/CT显示前列腺窝复发9例,盆腔淋巴转移8例,盆腔外淋巴结转移3例,骨转移12例,肺转移1例.结论 ^(18)F-PSMA-1007 PET/CT在低tPSA水平前列腺癌初诊及生化复发患者中有较高的诊断灵敏度、特异度和准确性.Objective To investigate the value of ^(18)F-prostatic specific membrane antigen(PSMA)-1007 PET/CT in the diagnosis.of prostate cancer with low serum total prostate specific antigen(tPSA)level and early biochemical recurrence.Methods Clinical data of patients undergoing ^(18)F PSMA-1007 PET/CT due to prostatic diseases were enrolled retrospectively.These patients were divided into two groups:the newly diagnosed group without any treatment(tPSA 4.0-20 ng/mL)and the biochemical recurrence group after radical prostatectomy(RP)(tPSA 0.2-10 ng/mL).The pathological results were the gold standard of the newly diagnosed group,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy.In the biochemical recurrence group,PET/CT results combined with other clinical data were used to determine whether there were recurrent foci or not,and the diagnostic efficacy was calculated.Results Of all 39 suspected patients in the newly diagnosed group,34 showed positive on PET/CT,including 1 false positive case.The tumor detection rate was 84.6%(33/39).The area under the curve(AUC)was 0.846,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 94.3%,75.0%,92.3%,97.1% and 60.0%.Of all the 33 true positive cases,PET/CT indicated 5 cases,3 cases,9 cases,and 1 case of pelvic lymph node metastasis,extra pelvic lymph node metastasis,bone metastasis and lung metastasis,respectively.PET/CT showed positive in 22 of 44 patients with biochemical recurrence,resulting in an overall detection rate of 50.0%,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 50.0%,80.0%,59.4%,84.6% and 42.1%,respectively.PET/CT indicated 9 cases,8 cases,3 cases,12 cases,and 1 case of prostate fossa metastasis,pelvic lymph node metastasis,extra pelvic lymph node metastasis,bone metastasis and lung metastasis,respectively.Conclusion ^(18)F-PSMA 1007 PET/CT has a high diagnostic sensitivity,specificity,and accuracy in low tPSA and in t

关 键 词：前列腺癌 血清总前列腺特异性抗原 ^(18)F-前列腺特异性膜抗原 正电子发射计算机体层成像 计算机体层成像 

分 类 号：R737.25[医药卫生—肿瘤] R446.8[医药卫生—临床医学] R814.42