^(18)F-FDG PET/CT显像和血清学指标对前列腺肿瘤的诊断价值  

Value of ^(18)F-FDG PET/CT and serological indicators in diagnosis of prostate tumor

作　　者：李晶[1] 张莺[1] Li Jing;Zhang Ying(Department of Nuclear Medicine,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院核医学科,浙江杭州310009

出　　处：《实用肿瘤杂志》2024年第3期280-283,共4页Journal of Practical Oncology

摘　　要：目的 研究^(18)F-氟代脱氧葡萄糖(^(18)F-fluorodexyglucose,^(18)F-FDG)PET/CT显像和前列腺血清学指标诊断前列腺肿瘤的价值。方法 回顾性分析2013年8月至2021年12月在浙江大学医学院附属第二医院经病理证实的95例疑似前列腺肿瘤患者的^(18)F-FDG PET/CT图像与前列腺血清学指标。根据病理检查结果分为恶性组(n=77)和良性组(n=18)。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析前列腺病灶的最大标准摄取值(maximum standardized uptake value,SUV_(max))与血清总前列腺特异性抗原(total prostate specific antigen,tPSA)、游离前列腺特异性抗原(free prostate specific antigen,fPSA)及游离/总前列腺特异性抗原比值(free/total prostate specific antigen,f/t-PSA)诊断前列腺良恶性病灶的最佳截断界值。结果 ROC曲线显示,SUV_(max)、tPSA、fPSA和f/t-PSA诊断前列腺良恶性病灶的最佳截断值分别为4.47、46.67 ng/mL、11.11 ng/mL和0.10。SUV_(max)、tPSA、fPSA和f/t-PSA的ROC曲线下面积(area under the curve,AUC)分别为0.658、0.897、0.842和0.836。^(18)F-FDG PET/CT显像、tPSA、f PSA和f/t-PSA对前列腺肿瘤的诊断敏感度分别是81.8%、97.4%、92.2%和83.1%,特异度分别是61.1%、27.8%、50.0%和50.0%,准确度分别是77.9%、84.2%、84.2%和76.8%。恶性组SUV_(max)、tPSA和fPSA均高于良性组,f/t-PSA低于良性组(均P<0.05)。^(18)F-FDG PET/CT检查显示,72例有远处转移病灶。结论 SUV_(max)、tPSA、fPSA和f/t-PSA均能鉴别前列腺良恶性病灶。^(18)F-FDG PET/CT显像在探测远处病灶方面更具有优势,能够为临床决策提供更好的帮助。Objective To investigate the diagnostic value of ^(18)F-fluorodexyglucose(^(18)F-FDG)PET/CT and prostate serological indicators in prostate tumor.Methods A total of 95 patients with ^(18)F-FDG PET/CT and serological indicators performed for prostate lesions con-firmed by pathology at the Second Affiliated Hospital,Zhejiang University School of Medicine,from August 2013 to December 2021,were analyzed retrospectively.The patients were divided into malignant group(n=77)and benign group(n=18).Receiver operating characteristic(ROC)curves were used to find out the cut-off value of the maximum standardized uptake value(SUV_(max)),total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),and free/total prostate specific antigen(f/t-PSA)for diagnosing prostate tumor.Results ROC curves showed that the cut-off values of SUV_(max),tPSA,fPSA,and f/t-PSA for diagnosing malignant prostate lesions were 4.47,46.67 ng/mL,11.11 ng/mL,and 0.10.The areas under the curves(AUCs)for SUV_(max),tPSA,fPSA,and f/t-PSA were 0.658,0.897,0.842,and 0.836.The sensitivity,specificity,and accuracy value obtained by ^(18)F-FDG PET/CT were 81.8%,61.1%,and 77.9%,respectively,97.4%,27.8%,and 84.2%by tPSA,92.2%,50.0%,and 84.2%by fPSA,and 83.1%,50.0%,and 76.8%by f/t-PSA.SUV_(max),tPSA,and fPSA in the malignant group were all significantly higher than those in the benign group(all P<0.05).f/t-PSA in the malignant group was significantly lower than that in the benign group(P<0.05).^(18)F-FDG PET/CT showed 72 patients with metastatic lesions.Conclusions SUV_(max),tPSA,fPSA,and f/t-PSA were effective indicators to identify benign and malignant prostate lesions.^(18)F-FDG PET/CT was more advantageous in exploring distant le-sions,providing better assistance for clinical decisions.

关 键 词：前列腺肿瘤 PET/CT 最大标准摄取值 前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤] R730.44[医药卫生—临床医学]