| 摘要: |
| 目的 探讨以68镓（68Ga）标记的靶向前列腺特异性膜抗原（PSMA）分子探针PSMA-11为示踪剂的PET-CT（68Ga-PSMA-11 PET-CT）辅助前列腺癌全病程管理的应用效果。方法 收集2019年1月31日至12月31日于海军军医大学（第二军医大学）长海医院接受68Ga-PSMA-11 PET-CT检查的386例前列腺癌患者的临床资料。回顾分析68Ga-PSMA-11 PET-CT对初诊、正在接受放射治疗和/或内分泌治疗、术后前列腺特异性抗原（PSA）水平持续升高或生化复发患者病灶转移和局部侵犯的检出情况。分析病灶总转移率及区域淋巴结转移、前列腺床侵犯或前列腺包膜外侵犯、骨转移、非区域淋巴结和/或脏器转移的发生情况。结果 160例初诊列腺癌患者中44.4%（71/160）发生病灶转移或局部侵犯，患者PSA水平≥ 30.0 ng/mL时69.0%（49/71）的患者发生病灶转移或局部侵犯，其中50.7%（36/71）发生骨转移。157例正在接受放射治疗和/或内分泌治疗的患者中，68.2%（107/157）发生病灶转移或局部侵犯，其中32.5%（51/157）为区域淋巴结转移、9.6%（15/157）为前列腺床侵犯、47.1%（74/157）为骨转移、19.7%（31/157）为非区域淋巴结和/或脏器转移。69例术后PSA水平持续升高或生化复发的前列腺癌患者中，52.2%（36/69）发生病灶转移或局部侵犯，其中17.4%（12/69）、11.6%（8/69）、5.8%（4/69）的患者仅分别发生区域淋巴结转移、骨转移、非区域淋巴结和/或脏器转移，2.9%（2/69）仅发生前列腺床侵犯，10.1%（7/69）发生区域淋巴结转移合并骨转移，2.9%（2/69）发生骨转移合并非区域淋巴结和/或脏器转移，1.4%（1/69）发生区域淋巴结转移合并非区域淋巴结和/或脏器转移。结论 对于PSA水平≥ 30.0 ng/mL的初诊前列腺癌患者，推荐行68Ga-PSMA-11 PET-CT检查进行术前评估；对于正在接受放射治疗和/或内分泌治疗的患者，68Ga-PSMA-11 PET-CT检查利于监测病情；对于术后PSA水平持续升高或生化复发的患者，68Ga-PSMA-11 PET-CT检查可明确病灶转移情况。 |
| 关键词: 前列腺肿瘤 前列腺特异性膜抗原 68镓 正电子发射断层显像计算机体层摄影术 |
| DOI：10.16781/j.0258-879x.2021.04.0355 |
| 投稿时间：2020-11-22修订日期：2021-04-06 |
| 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），促进市级医院临床技能与临床创新三年行动计划（SHDC2020CR6007）. |
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| 68Ga-PSMA PET-CT in managing prostate cancer at different stages: a single center retrospective study |
| SONG Zi-jian1△,WU Han-xiao1△,CHEN Rui1,CHENG Chao2,ZUO Chang-jing2,GAO Xu1* |
(1. Department of Urology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Nuclear Medicine, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the effects of 68gallium-labelled prostate-specific membrane antigen (PSMA) ligand PSMA-11 (68Ga-PSMA-11) positron emission tomography-computed tomography (PET-CT) in the management of prostate cancer at different stages. Methods The clinical data of 386 prostate cancer patients who underwent 68Ga-PSMA-11 PET-CT in Changhai Hospital of Naval Medical University (Second Military Medical University) from Jan. 31 to Dec. 31, 2019 were collected. We retrospectively analyzed the role of 68Ga-PSMA-11 PET-CT in detection of metastases or local invasion for untreated patients, patients undergoing radiotherapy and/or hormonal therapy, and postoperative patients with persistent prostate-specific antigen (PSA) elevation or biochemical recurrence. The incidence rates of total metastasis, regional lymph node metastasis, prostate bed invasion, extracapsular invasion of the prostate, bone metastasis, and non-regional lymph node and/or organ metastases were analyzed. Results Among the 160 untreated patients, 44.4% (71/160) had metastases. In the 71 untreated patients with PSA ≥ 30 ng/mL, 69.0% (49/71) had metastases or local invasion, of which 50.7% (36/71) had bone metastases. In the 157 patients undergoing radiotherapy and/or hormonal therapy, 68.2% (107/157) had metastases or local invasion, of which 32.5% (51/157) had regional lymph node metastases, 9.6% (15/157) had prostate bed invasion, 47.1% (74/157) had bone metastases, and 19.7% (37/157) had non-regional lymph nodes and/or organ metastases. Among the 69 postoperative patients with persistent PSA elevation or biochemical recurrence, 52.2% (36/69) had metastases or local invasion, of which 17.4% (12/69), 11.6% (8/69), and 5.8% (4/69) only had regional lymph nodes, bone, and non-regional lymph node and/or organ metastases, respectively; 2.9% (2/69) only had prostate bed invasion, 10.1% (7/69) had regional lymph node and bone metastases, 2.9% (2/69) had bone and non-regional lymph node and/or organ metastases, and 1.4% (1/69) had regional lymph node and non-regional lymph node and/or organ metastases. Conclusion For untreated prostate cancer patients with PSA ≥ 30 ng/mL, 68Ga-PSMA-11 PET-CT is recommended for preoperative evaluation; for patients undergoing radiotherapy and/or hormonal therapy, it can be used to monitor the progression of prostate cancer; and for postoperative patients with persistent PSA elevation or biochemical recurrence, it is recommended to detect metastasis. |
| Key words: prostatic neoplasms prostate-specific membrane antigen 68gallium positron emission tomography-computed tomography |
