^(18)F-PSMA-1007 PET/CT联合血清前列腺总特异性抗原预测前列腺癌国际泌尿病理协会病理分级的临床价值  

Clinical value of^(18)F-PSMA-1007 PET/CT combined with serum total prostate specific antigen in predicting International Society of Urological Pathology pathological grading of prostate cancer

作　　者：薄云峰[1] 田蓉蓉[2] 保兰兰 赵铭[2] 周洁[2] 李合 郝海龙[4] 徐恩伟[1] Bo Yunfeng;Tian Rongrong;Bao Lanlan;Zhao Ming;Zhou Jie;Li He;Hao Hailong;Xu Enwei(Department of Pathology,Shanxi Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Nuclear Medicine PET/CT Center,Shanxi Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Statistics,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of Urology,Shanxi Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院病理科,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院核医学PET/CT中心,太原030013 [3]山西医科大学公共卫生学院统计学教研室,太原030013 [4]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院泌尿外科,太原030013

出　　处：《中华肿瘤杂志》2025年第2期175-182,共8页Chinese Journal of Oncology

摘　　要：目的探讨前列腺癌国际泌尿病理协会(ISUP)病理分级与^(18)F-前列腺特异性膜抗原(PSMA)-1007 PET/CT参数和血清前列腺总特异性抗原(tPSA)的相关性,评价通过^(18)F-PSMA-1007 PET/CT预测前列腺癌ISUP病理分级的临床价值。方法回顾性分析2018年8月至2024年2月经山西省肿瘤医院病理科确诊并行^(18)F-PSMA-1007 PET/CT显像的117例前列腺癌初诊患者ISUP病理分级与PET/CT主要参数和tPSA的相关性。采用单因素和多因素logistic回归分析明确前列腺癌ISUP病理分级的独立影响因素,采用受试者工作特征(ROC)曲线评价^(18)F-PSMA-1007 PET/CT图像主要参数预测前列腺癌ISUP高级别与低级别分组的效能。结果117例患者中,ISUP病理分级为ISUP1级20例,ISUP2级25例,ISUP3级18例,ISUP4级32例,ISUP5级22例;低级别组63例,高级别组54例。117例患者的肿瘤长径为3.10(2.05,4.25)cm,前列腺体积为40.11(33.13,51.85)cm 3,tPSA为19.71(12.25,42.83)ng/ml,前列腺特异性抗原密度(PSAD)为0.51(0.31,1.01)ng·ml^(-1)·cm^(-3),病灶最大标准摄取值(SUVmax)为15.24(10.87,22.03),肿瘤/脾脏摄取比值(TSR)为1.61(1.08,2.15)。相关分析显示,SUVmax、TSR、血清tPSA与ISUP病理分级均呈正相关(r分别为0.640、0.619和0.500,均P<0.01)。ISUP1级组、ISUP2级组、ISUP3级组、ISUP4级组和ISUP5级组的肿瘤长径、血清tPSA、PSAD、病灶SUVmax、TSR差异均有统计学意义(均P<0.001),低级别组与高级别组患者的肿瘤长径、血清tPSA、PSAD、病灶SUVmax、TSR差异也均有统计学意义(均P<0.01)。多因素logistic回归分析显示,血清tPSA(OR=1.042,95%CI:1.014~1.070)和TSR(OR=4.172,95%CI:2.095~8.308)是前列腺癌ISUP病理分级分组的独立影响因素。ROC分析显示,^(18)F-PSMA-1007 PET/CT参数SUVmax、TSR预测前列腺癌ISUP低级别或高级别的曲线下面积分别为0.800(95%CI:0.717~0.883)和0.797(95%CI:0.713~0.881)。行前列腺癌根治术的70例患者中,ISUP高级别患者术后复发率为54.8%(17/31),高�Objective To discuss the correlation of International Society of Urological Pathology(ISUP)pathological grading with^(18)F-prostate specific membrane antigen(PSMA)-1007 positron emission tomography-computed tomography(PET/CT)parameters and serum total prostate specific antigen(tPSA)in prostate cancer,and assess the clinical value of PET/CT combined with tPSA in predicting the ISUP pathological grade of prostate cancer.Methods The correlation of ISUP pathological grade with primary parameters of PET/CT images and serum tPSA of 117 patients diagnosed with prostate cancer at Shanxi Cancer Hospital from August 2018 to February 2023 and taken^(18)F-PSMA-1007 PET/CT imaging were retrospectively analyzed.Univariate and multivariate logistic regressions were used to identify the independent influencing factors for ISUP pathological grading of prostate cancer.The receiver operating characteristic(ROC)curves were used to predict the efficacy between the high and low ISUP grades for prostate cancer.Results Of the 117 patients,20 were in ISUP Group 1,25 in Group 2,18 in Group 3,32 in Group 4,and 22 in Group 5.Of these,63 were in the low-grade group(Groups 1-3)and 54 were in the high-grade group(Groups 4-5).The tumor long diameter was 3.10(2.05,4.25)cm,the prostate volume was 40.11(33.13,51.85)cm 3,the serum tPSA was 19.71(12.25,42.83)ng/ml,the prostate specific antigen density(PSAD)was 0.51(0.31,1.01)ng·ml^(-1)·cm^(-3),the maximum standard uptake value of the lesion(SUVmax)was 15.24(10.87,22.03),and the tumor/spleen uptake ratio(TSR)was 1.61(1.08,2.15)in the 117 patients.The correlation analysis displayed that the SUVmax,TSR,and tPSA were positively correlated with ISUP groups(r=0.640,0.619,and 0.500,P<0.01).The differences among SUVmax,TSR,long diameter,tPSA,and PSAD were statistically significant when compared among the five ISUP groups(H=48.98,45.63,26.82,33.95,and 23.81,P<0.001).The differencesin serum tPSA(z=5.19),PSAD(z=4.64),long diameter(z=3.19),SUVmax(z=5.57),and TSR(z=5.53)of the patients between the low-grade gr

关 键 词：前列腺肿瘤 前列腺特异性膜抗原 正电子发射计算机体层摄影 病理分级 国际泌尿病理协会 

分 类 号：R737.25[医药卫生—肿瘤]