^(68)Ga-PSMA-11 PET/CT在前列腺癌根治术后生化复发患者中的检出率及病灶分布特征分析  

Detection rate of ^(68)Ga-PSMA-11 PET/CT and distribution characteristics of lesions in patients with biochemical recurrence after radical prostatectomy for prostate cancer

作　　者：陈翘楚 王一宁 周翔[1] 王成[1] 赵海涛 万良荣[1] 陈若华 刘建军[1] Chen Qiaochu;Wang Yining;Zhou Xiang;Wang Cheng;Zhao Haitao;Wan Liangrong;Chen Ruohua;Liu Jianjun(Department of Nuclear Medicine,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院核医学科,上海200127

出　　处：《中华核医学与分子影像杂志》2024年第9期528-532,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金(92259103)。

摘　　要：目的评估^(68)Ga-前列腺特异膜抗原(PSMA)-11 PET/CT在前列腺癌根治术后生化复发(BCR)患者中的检出率及病灶分布特征。方法回顾性分析2020年1月至2024年3月在上海交通大学医学院附属仁济医院行^(68)Ga-PSMA-11 PET/CT检查的172例前列腺癌根治术后BCR患者[年龄(69.4±6.5)岁]。探讨前列腺特异抗原(PSA)水平与^(68)Ga-PSMA-11 PET/CT检出率的关系;对经局部治疗后明确部位的BCR患者, 分析^(68)Ga-PSMA-11 PET/CT检出病灶的部位和数量, 采用Fisher确切概率法分析数据。结果 ^(68)Ga-PSMA-11 PET/CT在BCR患者中的阳性检出率为70.35%(121/172), 阳性检出率随PSA水平升高而升高, 0.2 μg/L≤PSA<0.5 μg/L、0.5 μg/L≤PSA<1.0 μg/L、1.0 μg/L≤PSA<1.5 μg/L、PSA≥1.5 μg/L组阳性检出率分别为49.12%(28/57)、67.24%(39/58)、15/16、95.12%(39/41)。64例经局部治疗后明确诊断为复发转移灶95个, 其中单纯前列腺床复发22例(34.38%)、单纯淋巴结转移23例(35.94%)、单纯骨转移7例(10.94%)、多区域转移12例(18.75%), 骨转移比例(18.75%, 12/64)明显低于前列腺床复发和淋巴结转移[均50.00%(32/64);均P=0.002]。结论 ^(68)Ga-PSMA-11 PET/CT在前列腺癌根治术后BCR患者中具有较高的检出率, 尤其是在PSA水平较高患者中。前列腺床和淋巴结是BCR患者主要转移部位, 而骨转移相对较少, 为今后BCR患者更精准治疗方案的选择提供了理论依据。ObjectiveTo evaluate the detection rate and distribution characteristics of lesions in patients with biochemical recurrence(BCR)after radical prostatectomy for prostate cancer by ^(68)Ga-prostate specific membrane antigen(PSMA)-11 PET/CT.MethodsFrom January 2020 to March 2024,^(68)Ga-PSMA-11 PET/CT examination results of 172 patients(age(69.4±6.5)years)with BCR after radical prostatectomy in Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively analyzed.The relationship between prostate specific antigen(PSA)levels and ^(68)Ga-PSMA-11 PET/CT detection rate was explored.The location and quantity of lesions detected by ^(68)Ga-PSMA-11 PET/CT were analyzed in BCR patients with clear location after local treatment,and data were analyzed by Fisher exact test.ResultsThe detection rate of ^(68)Ga-PSMA-11 PET/CT in patients with BCR was 70.35%(121/172).The positive detection rate increased with the increase of PSA level,with detection rates of 0.2μg/L≤PSA<0.5μg/L,0.5μg/L≤PSA<1.0μg/L,1.0μg/L≤PSA<1.5μg/L and PSA≥1.5μg/L groups of 49.12%(28/57),67.24%(39/58),15/16 and 95.12%(39/41),respectively.After local treatment,64 cases were diagnosed with 95 recurrent and metastatic lesions.Among them,22(34.38%)had simple prostate bed recurrence,23(35.94%)had simple lymph node metastasis,7(10.94%)had simple bone metastasis,and 12(18.75%)had multi regional metastasis.The proportion of bone metastasis(18.75%,12/64)was significantly lower than that of prostate bed recurrence and lymph node metastasis(both 50.00%(32/64);both P=0.002).Conclusions ^(68)Ga-PSMA-11 PET/CT has a high detection rate in patients with BCR after radical prostatectomy,especially in patients with high PSA levels.The lesions are mainly distributed in the prostate bed and lymph nodes,while bone metastases are relatively rare,which provide a theoretical basis for the selection of more accurate treatment plans for BCR patients in the future.

关 键 词：前列腺肿瘤 复发 前列腺特异膜抗原 同位素标记 镓放射性同位素 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]