前列腺癌双探针PET/CT显像的肿瘤负荷及转移与血清前列腺特异性抗原的相关性  

Correlation of tumor load,metastasis and serum prostate specific antigen with dual probe PET/CT imaging in prostate cancer patients

作　　者：许佳玮 刘长青[2] 宋振国[2] 姬琳琳 李现军[2] XU Jiawei;LIU Changqing;SONG Zhenguo;JI Linlin;LI Xianjun(School of Medical Imaging of Weifang Medical University,Weifang 261053,China;Department of Nuclear Medicine,Weifang People's Hospital,Weifang 261041,China)

机构地区：[1]潍坊医学院医学影像学院,山东潍坊261053 [2]潍坊市人民医院核医学科,山东潍坊261041

出　　处：《分子影像学杂志》2023年第4期648-653,共6页Journal of Molecular Imaging

基　　金：潍坊市卫生健康委科研项目(WFWSJK-2022-020)。

摘　　要：目的以18氟-脱氧葡萄糖(^(18)F-FDG)及18氟-前列腺特异性膜抗原(^(18)F-PSMA)双探针PET/CT显像为基础,探究前列腺癌患者的肿瘤负荷和肿瘤转移与血清前列腺特异性抗原(PSA)的关系。方法选择2021年3月1日~2022年11月27日潍坊市人民医院经病理组织学确诊的初诊前列腺癌患者共54例,行^(18)F-FDG及^(18)F-PSMA双探针PET/CT检查。依据双探针PET/CT检查及临床资料分为无转移组(n=16)与转移组(n=38),统计所有患者双探针PET/CT检查确定的肿瘤负荷指标,采用Spearman检验对血清PSA与肿瘤负荷指标进行相关性分析,采用Mann-Whitney U检验进行组间比较。结果两组的血清PSA、全身代谢体积、原发灶表达体积、糖酵解总量及表达总量差异均有统计学意义(P<0,05);血清PSA>31,83μg/L时检测前列腺癌转移的效能最佳,敏感度及特异性分别为84.21%和93.75%;经双探针PET/CT检查获取的各项肿瘤负荷均与血清PSA具有相关性(P<0.01)。结论血清PSA越高提示前列腺癌肿瘤负荷越大,转移组肿瘤负荷均高于无转移组,患者血清PSA>31.83μg/L时,提示发生前列腺癌转移的可能性大,有必要行^(18)F-PSMA PET/CT显像全面评估。Objective To investigate the correlation between tumor burden,metastasis and serum prostate specific antigen(PSA)in prostate cancer patients based on the dual-probe PET/CT imaging of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)and ^(18)F-prostate specific membrane antigen(^(18)F-PSMA).Methods Fifty-four patients with primary prostate cancer diagnosed by pathological histology from March 1st,2021 to November 27th,2022 in Weifang People's Hospital.The patients underwent ^(18)F-FDG and ^(18)F-PSMA dual probe PET/CT.Based on the dual-probe PET/CT examination and clinical data,the patients were divided into metastasis-free group(n=16)and metastasis group(n=38),and the tumor load indexes determined by dual-probe PET/CT examination were counted in all patients.Spearman test was used to analyze the correlation between serum PSA and tumor burden index,and Mann-Whitney U test was used to compare between groups.Results The differences of serum PSA,metabolic tunour volume,volume of PSMA,total lesion glycolysis and total lesion uptake value of PSMA between the two groups were statistically significant(P<0.05).The efficacy of detecting prostate cancer metastasis was best at serum PSA>31.83μg/L,with sensitivity and specificity of 84.21%and 93.75%,respectively.The tumor burden obtained by dual-probe PET/CT were significantly correlated with serum PSA(P<0.01).Conclusion The higher the serum PSA,the greater the tumour load of prostate cancer.The tumour load of the metastatic group is higher than that of the non-metastatic group.Patients with a serum PSA>31.83μg/L indicates a high probability of metastatic prostate cancer and necessitated a comprehensive assessment with ^(18)F-PSMA PET/CT imaging.

关 键 词：前列腺肿瘤 前列腺特异膜抗原 氟放射性同位素 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] R730.44[医药卫生—临床医学]