摘要
目的探讨以^(68)镓(^(68)Ga)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(^(68)Ga-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^(68)Ga-PSMA-11 PET-CT检查的386例前列腺癌患者的临床资料。回顾分析^(68)Ga-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^(68)Ga-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,^(68)Ga-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,^(68)Ga-PSMA-11 PET-CT检查可明确病灶转移情况。
Objective To explore the effects of 68gallium-labelled prostate-specific membrane antigen(PSMA)ligand PSMA-11(^(68)Ga-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 ^(68)Ga-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 ^(68)Ga-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,^(68)Ga-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.
作者
宋子健
吴涵潇
陈锐
程超
左长京
高旭
SONG Zi-jian;WU Han-xiao;CHEN Rui;CHENG Chao;ZUO Chang-jing;GAO Xu(Department of Urology,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Nuclear Medicine,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2021年第4期355-360,共6页
Academic Journal of Second Military Medical University
基金
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).
