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初诊前列腺癌患者代谢体积参数与临床指标的相关性
温健男1,2,程超1,章泽宇1,姜鸿媛1,谷振勇1,左长京1*
0
(1. 海军军医大学(第二军医大学)长海医院核医学科, 上海 200433;
2. 北部战区总医院第一派驻门诊部, 沈阳 110001
*通信作者)
摘要:
目的 探索初诊前列腺癌(PCa)患者68镓标记的前列腺特异性膜抗原(68Ga-PSMA)-11 PET-CT的代谢体积参数与临床指标的相关性。方法 回顾性分析2019年1月至12月经前列腺活体组织穿刺病理学确诊,于海军军医大学(第二军医大学)长海医院行68Ga-PSMA-11 PET-CT检查的85例未经治疗PCa患者的影像学及临床资料。85例患者中未发生肿瘤转移的有46例(无转移组)、发生肿瘤转移的有39例(转移组)。采用Spearman秩相关检验分别分析两组患者原发灶最大标准摄取值(SUVmax),原发灶平均标准摄取值(SUVmean)及病灶前列腺特异性膜抗原(PSMA)总量(TL-PSMA)等多个代谢体积参数与年龄、BMI、格里森评分(GS)、前列腺特异性抗原(PSA)等临床指标的相关性。结果 无转移组中,PSA与原发灶SUVmax、原发灶TL-PSMA呈中度正相关(rs=0.409,P=0.005;rs=0.587,P<0.001);而GS与原发灶SUVmax、原发灶TL-PSMA不相关(rs=0.181,P=0.229;rs=0.101,P=0.505)。转移组中,PSA与原发灶TL-PSMA、转移灶TL-PSMA、全身病灶TL-PSMA呈中度正相关(rs=0.439,P=0.005;rs=0.588,P<0.001;rs=0.569,P<0.001),与原发灶SUVmax不相关(rs=0.255,P=0.117);而GS与原发灶SUVmax、原发灶TL-PSMA、转移灶TL-PSMA、全身病灶TL-PSMA均不相关(rs=0.069,P=0.675;rs=0.194,P=0.237;rs=0.299,P=0.064;rs=0.300,P=0.063)。结论 反映初诊PCa患者全身肿瘤负荷的代谢体积参数TL-PSMA与血清PSA呈正相关,而与反映原发灶分化程度的GS不相关。
关键词:  前列腺特异性膜抗原  正电子发射断层显像计算机体层摄影术  前列腺肿瘤  代谢体积参数  肿瘤负荷
DOI:10.16781/j.0258-879x.2021.01.0063
投稿时间:2020-09-05修订日期:2020-12-04
基金项目:上海市卫生健康委员会先进适宜技术推广项目(2019SY029),海军军医大学(第二军医大学)长海医院“234学科攀峰计划”(2019YPT002).
Correlation between metabolic volume parameters and clinical indicators in patients with newly diagnosed prostate cancer
WEN Jian-nan1,2,CHENG Chao1,ZHANG Ze-yu1,JIANG Hong-yuan1,GU Zhen-yong1,ZUO Chang-jing1*
(1. Department of Nuclear Medicine, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. The First Outpatient Department, General Hospital of PLA Northern Theater Command, Shenyang 110001, Liaoning, China
*Corresponding author)
Abstract:
Objective To explore the correlation between 68Gallium-prostate-specific membrane antigen (68Ga-PSMA)-11 positron emission tomography-computed tomography (PET-CT)-derived metabolic volume parameters and clinical indicators of patients with newly diagnosed prostate cancer (PCa). Methods The imaging and clinical data of untreated 85 patients with PCa diagnosed by prostate biopsy who underwent 68Ga-PSMA-11 PET-CT in Changhai Hospital, Naval Medical University (Second Military Medical University) from Jan. to Dec. 2019 were retrospectively analyzed; 46 patients without tumor metastasis were included in the non-metastasis group and 39 with tumor metastasis in the metastasis group. Spearman rank correlation test was performed to analyze the correlation between metabolic volume parameters (primary tumor maximum standardized uptake value[SUVmax], mean standardized uptake value[SUVmean] of primary tumor, total lesion of prostate-specific membrane antigen[TL-PSMA]) and clinical indicators (age, body mass index, Gleason score[GS], and prostate-specific antigen[PSA]) of the two groups. Results In the non-metastasis group, PSA was moderately positively correlated with primary tumor SUVmax and primary tumor TL-PSMA (rs=0.409, P=0.005; rs=0.587, P<0.001), while GS was not correlated with primary tumor SUVmax and primary tumor TL-PSMA (rs=0.181, P=0.229; rs=0.101, P=0.505). In the metastasis group, PSA was moderately positively correlated with primary tumor TL-PSMA, metastasic tumor TL-PSMA and whole-body TL-PSMA (rs=0.439, P=0.005; rs=0.588, P<0.001; rs=0.569, P<0.001), but not correlated with primary tumor SUVmax (rs=0.255, P=0.117); while GS was not correlated with primary tumor SUVmax, primary tumor TL-PSMA, metastasic tumor TL-PSMA and whole-body TL-PSMA (rs=0.069, P=0.675; rs=0.194, P=0.237; rs=0.299, P=0.064; rs=0.300, P=0.063). Conclusion The metabolic volume parameter TL-PSMA, which reflects the systemic tumor burden in patients with newly diagnosed PCa, is positively correlated with serum PSA, but not with GS, which reflects the differentiation degree of primary tumor.
Key words:  prostate-specific membrane antigen  positron emission tomography computed tomography  prostatic neoplasms  metabolic volume parameter  tumor burden