mpMRI及^(18)F-PSMA PET/CT结果与根治性前列腺切除术后病理升级的相关性  

Correlation between results of mpMRI and ^(18)F-PSMA PET/CT with pathological upgrade after radical prostatectomy

作　　者：敖砾言 牛少曦[2] 许勇[2] 张旭[2] Ao Liyan;Niu Shaoxi;Xu Yong;Zhang Xu(Graduate School of Chinese PLA Medical School,Beijing 100853,China;Department of Urolo-gy,Chinese PLA General Hospital,Beijing 100039)

机构地区：[1]解放军医学院研究生院,北京100853 [2]中国人民解放军总医院泌尿外科医学部,北京100039

出　　处：《微创泌尿外科杂志》2023年第1期58-62,共5页Journal of Minimally Invasive Urology

摘　　要：目的:探究前列腺癌患者机器人辅助根治性前列腺切除术后病理升级与术前mpMRI和^(18)F-PSMA PET/CT检查结果的相关性。方法:回顾性收集2019年1月至2022年10月在中国人民解放军总医院第一医学中心就诊的符合条件前列腺癌患者96例,根据其术前影像结果及是否发生病理升级分组,分析其病理升级的影响因素。结果:41(42.7%)例患者发生病理升级,其中术前tPSA、PSAD、穿刺ISUP分级、术后ISUP分级、两项影像检查均阳性在病理升级与非升级组间有统计学差异(P<0.05)。多因素Logistic回归分析提示穿刺ISUP分级(OR=0.476,95%CI:0.301-0.753;P=0.002)及两项影像结果均阳性(OR=5.135,95%CI:1.370-19.243;P=0.015)是发生病理升级的独立影响因素。术前mpMRI及PSMA PET/CT检查均阳性患者72(75%)例,其病理升级率较非均阳性患者有统计学差异(48.6%vs.25.0%,P=0.043)。结论:穿刺ISUP分级及两项影像结果均阳性是病理升级的独立影响因素,两项影像检查阳性患者具有更高病理升级风险。Objective:To investigate the correlation between preoperative results of mpMRI and ^(18)F-PSMA PET/CT and pathological upgrade in patients suffered robot-assisted radical prostatectomy.Method:A total of 96 eligible patients who were admitted to the Department of Urology in First Medical Center of the Chinese PLA Gener⁃al Hospital from January 2019 to October 2022 were included.According to their imaging results and whether patho⁃logical upgrade was occurred,they were divided into different groups.The risk factors of pathological upgrade were evaluated respectively.Results:41(42.7%)patients were reported with pathological upgrade.Statistically signifi⁃cant difference was found in preoperative tPSA,fPSA,PSAD,ISUP grade of biopsy and postoperative specimens and positive results of both images between pathological upgrade and non-upgrade group.ISUP grade of biopsy(OR=0.476,95%CI:0.301-0.753;P=0.002)and positive results of both images(OR=5.135,95%CI:1.370-19.243;P=0.015)are independent risk factors of pathologicalupgrade evaluated by multivariate logistic regression analysis.72(75%)patients had positive results of both mpMRI and PSMA PET/CT,and there was a statistically significant dif⁃ference in the rate of pathological upgrade from not-both-positive results of imaging(48.6%vs.25.0%,P=0.043).Conclusion:ISUP grade of biopsy and positive results of both mpMRI and PSMA PET/CT are independent risk fac⁃tors ofpathological upgrade.Patients with positive results of both two images have high risk of pathological upgrade.

关 键 词：前列腺肿瘤 正电子发射计算机断层摄影术 磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤]