1.中山大学附属第三医院核医学科,广东 广州 510630
2.中山大学公共卫生学院医学统计学系 广东 广州 510080
李建芳,硕士,主治医师,研究方向为核素治疗与分子影像, E-mail: lijianfang926@163.com
收稿:2021-01-22,
纸质出版:2021-05-20
移动端阅览
李建芳,万麒昌,秦露平等.68Ga-PSMA-11 PET/CT双时相SUVmax与前列腺癌临床病理特征的相关性[J].中山大学学报(医学科学版),2021,42(03):448-454.
LI Jian-fang,WAN Qi-chang,QIN Lu-ping,et al.Correlation Analysis between SUVmax in Dual-phase 68Ga-PSMA-11 PET/CT and the Clinicopathologic Features of Patients with Prostate Cancer[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(03):448-454.
李建芳,万麒昌,秦露平等.68Ga-PSMA-11 PET/CT双时相SUVmax与前列腺癌临床病理特征的相关性[J].中山大学学报(医学科学版),2021,42(03):448-454. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0116.
LI Jian-fang,WAN Qi-chang,QIN Lu-ping,et al.Correlation Analysis between SUVmax in Dual-phase 68Ga-PSMA-11 PET/CT and the Clinicopathologic Features of Patients with Prostate Cancer[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(03):448-454. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0116.
目的
2
探讨
68
Ga-PSMA-11 PET/CT双时相前列腺癌原发病灶最大标准摄取值(SUVmax)与初诊前列腺癌患者各项临床病理特征的相关性。
方法
2
回顾性收集我院2017年11月至2020年9月期间初次确诊为前列腺癌的患者,共19例,年龄(69.0±7.4)岁。所有患者均行
68
Ga-PSMA-11 PET/CT双时相检查,检查后两周内均行前列腺癌根治术。通过阈值自动分割法,计算出前列腺癌原发病灶在标准相SUVmax1、延迟相SUVmax2、双时相SUVmax差值SUVmax3。收集所有病人的临床、病理资料。采用Mann-Whitney
U
检验、受试者工作特征(ROC)曲线分析SUVmax值与患者临床病理特点的关系,以
P
<
0.05标准为差异有统计学意义。
结果
2
SUVmax1、SUVmax2、SUVmax3在格林森评分(GS)≤7组与GS>7组的组间差异均有统计学意义(
P
<0.05),ROC曲线下面积分别为0.845、0.845、0.893。SUVmax1、SUVmax2、SUVmax3在国际泌尿病理学会(International Society of Urological Pathology, ISUP)分级≤2组与ISUP>2组的组间差异均有统计学意义(
P
<0.05),ROC曲线下面积分别为0.773、0.784、0.852。SUVmax3在T分期≤T2组与T分期>T2组的组间差异有统计学意义(
P
<0.05),而SUVmax1、SUVmax2在T分期≤T2组与T分期>T2组的组间差异均没有统计学意义(
P>
0.05)。SUVmax3在D’Amico低中危组与高危组的组间差异有统计学意义(
P
<0.05),而SUVmax1、SUVmax2在D’Amico低中危组与高危组的组间差异均没有统计学意义(
P>
0.05)。SUVmax1、SUVmax2、SUVmax3在总PSA≤20 ng/mL组与>20 ng/mL组的组间差异均没有统计学意义(
P>
0.05)。SUVmax1、SUVmax2、SUVmax3在神经侵犯阳性组与阴性组的组间差异均有统计学意义(
P
<0.05),ROC曲线下面积分别为0.872、0.923、0.974。
结论
2
SUVmax2、SUVmax3与前列腺癌多项临床、病理特征呈密切正相关,与标准相比较,
68
Ga-PSMA-11 PET/CT双时相显像在前列腺癌术前的临床、病理特征的预测方面或许可提供更有利的价值。
Objective
2
The purpose of this study was to analyze the correlation between SUVmax on primary prostate lesion of two-phase
68
Ga-PSMA-11 PET/CT and the clinicopathological features of patients with preliminary diagnosis of prostate cancer.
Methods
2
PET/CT images of 19 patients with prostate cancer first diagnosed in our hospital from November 2017 to September 2020, aged 69.0±7.4 years, were collected. All patients underwent
68
Ga-PSMA-11 PET/CT dual-phase examination, and radical resection of prostate cancer was performed within two weeks. Semi-quantitative parameters of
68
Ga-PSMA-11 PET/CT on primary prostate cancer, SUVmax1 in the standard phase imaging, SUVmax2 in the delayed phase imaging and SUVmax3 (difference between SUVmax2 and SUVmax1), were measured by automatic segmentation algorithm method. Clinical and pathological data of each patient were collected. Mann-Whitney
U
test and ROC curve analysis were used to compare SUVmax and the clinicopathological characteristics of patients in two independent samples.
P
<
0.05 was considered as statistically significant difference.
Results
2
The differences of SUVmax1, SUVmax2 and SUVmax3 between GS≤7 group and
>
7 group were statistically significant(
P
<0.05), and the areas under the ROC curves were 0.845, 0.845 and 0.893, respectively. SUVmax1, SUVmax2 and SUVmax3 were significantly different between ISUP grade ≤2 group and
>
2 group (
P
<
0.05), and the areas under the ROC curve were 0.773, 0.784 and 0.852, respectively. The difference of SUVmax3 between T stage ≤T2 group and
>
T2 group was statistically significant (
P
<
0.05), while the difference of SUVmax1 and SUVmax2 between T stage ≤T2 group and
>
T2 group was not statistically significant (
P
>
0.05). The difference of SUVmax3 between D’ Amico low-medium-risk group and high-risk group was statistically significant (
P
<
0.05), while the difference of SUVmax1 and SUVmax2 between D’ Amico low-medium-risk group and high-risk group was not statistically significant (
P
>
0.05). There was no significant difference in SUVmax1, SUVmax2 and SUVmax3 between total PSA ≤20 ng/mL group and
>
20 ng/mL group (
P
>
0.05). SUVmax1, SUVmax2 and SUVmax3 were significantly different between positive nerve invasion group and negative group (
P
<
0.05), and the areas under the ROC curves were 0.872, 0.923 and 0.974, respectively.
Conclusions
2
SUVmax2 and SUVmax3 were positively correlated with multiple clinical and pathological features of prostate cancer. Compared with standard phase imaging, dual-phase imaging of
68
Ga-PSMA-11 PET/CT may provide more favorable value in predicting the clinical and pathological features of prostate cancer patients before surgery.
Bray F , Ferlay J , Soerjomataram I , et al . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J]. CA Cancer J Clin , 2018 , 68 ( 6 ): 394 - 424 .
陈业辉 , 赵仕佳 , 仉智 , 等 . 前列腺癌患者3年生存的预测因素分析 [J]. 中山大学学报(医学科学版) , 2016 , 37 ( 2 ): 300 - 304 .
Chen YH , Zhao SJ , Zhang Z , et al . Predictive factors of 3-year survival in patients with prostate cancer [J]. J SUN Yat-sen Univ (Med Sci) , 2016 , 37 ( 2 ): 300 - 304 .
Hollemans E , Verhoef EI , Bangma CH , et al . Cribriform architecture in radical prostatectomies predicts oncological outcome in Gleason score 8 prostate cancer patients [J]. Mod Pathol , 2021 , 34 ( 1 ): 184 - 193 .
Alqahtani S , Wei C , Zhang Y , et al . Prediction of prostate cancer Gleason score upgrading from biopsy to radical prostatectomy using pre-biopsy multiparametric MRI PIRADS scoring system [J]. Sci Rep , 2020 , 10 ( 1 ): 7722 .
Thoma C . PSMA PET-CT outperforms conventional imaging in high-risk prostate cancer [J]. Nat Rev Urol , 2020 , 17 ( 6 ): 319 .
Koerber SA , Utzinger MT , Kratochwil C , et al . 68 Ga-PSMA-11 PET/CT in newly diagnosed carcinoma of the prostate: correlation of intraprostatic PSMA uptake with several clinical parameters [J]. J Nucl Med , 2017 , 58 ( 12 ): 1943 - 1948 .
Schmuck S , Nordlohne S , von Klot CA , et al . Comparison of standard and delayed imaging to improve the detection rate of 68 Ga-PSMA I & T PET/CT in patients with biochemical recurrence or prostate-specific antigen persistence after primary therapy for prostate cancer [J]. Eur J Nucl Med Mol Imaging , 2017 , 44 ( 6 ): 960 - 968 .
Beheshti M , Manafi-Farid R , Geinitz H , et al . Multiphasic 68 Ga-PSMA PET/CT in the detection of early recurrence in prostate cancer patients with a PSA level of less than 1 ng/mL: a prospective study of 135 patients [J]. J Nucl Med , 2020 , 61 ( 10 ): 1484 - 1490 .
Afshar-Oromieh A , Sattler LP , Mier W , et al . The clinical impact of additional late PET/CT imaging with 68 Ga-PSMA-11 (HBED-CC) in the diagnosis of prostate cancer [J]. J Nucl Med , 2017 , 58 ( 5 ): 750 - 755 .
Schmuck S , Mamach M , Wilke F , et al . Multiple time-point 68 Ga-PSMA I & T PET/CT for characterization of primary prostate cancer: value of early dynamic and delayed imaging [J]. Clin Nucl Med , 2017 , 42 ( 6 ): e286 - e293 .
Buyyounouski MK , Choyke PL , Mckenney JK , et al . Prostate cancer-major changes in the American Joint Committee on Cancer eighth edition cancer staging manual [J]. CA Cancer J Clin , 2017 , 67 ( 3 ): 245 - 253 .
D'Amico AV , Whittington R , Malkowicz SB , et al . Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer [J]. JAMA , 1998 , 280 ( 11 ): 969 - 974 .
Offermann A , Hupe MC , Sailer V , et al . The new ISUP 2014/WHO 2016 prostate cancer grade group system: first resume 5 years after introduction and systemic review of the literature [J]. World J Urol , 2020 , 38 ( 3 ): 657 - 662 .
Afshar-Oromieh A , Malcher A , Eder M , et al . PET imaging with a [ 68 Ga] gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions [J]. Eur J Nucl Med Mol Imaging , 2013 , 40 ( 4 ): 486 - 495 .
Sahlmann CO , Meller B , Bouter C , et al . Biphasic 68 Ga-PSMA-HBED-CC-PET/CT in patients with recurrent and high-risk prostate carcinoma [J]. Eur J Nucl Med Mol Imaging , 2016 , 43 ( 5 ): 898 - 905 .
蒋翠萍 , 臧士明 , 等 . 68 Ga-PSMA-11PET/CT对未经治疗前列腺癌的临床决策的影响 [J]. 临床泌尿外科杂志 , 2018 , 33 ( 7 ): 551 - 555 .
Jiang CP , Zang SM , Xu L , et al . Role of 68 Ga-PSMA-11PET/CT in the clinical management of naïve prostate carcinoma [J]. J Clin Urology (China) , 2018 , 33 ( 7 ): 551 - 555 .
Sathekge M , Lengana T , Maes A , et al . 68 Ga-PSMA-11 PET/CT in primary staging of prostate carcinoma: preliminary results on differences between black and white South-Africans [J]. Eur J Nucl Med Mol Imaging , 2018 , 45 ( 2 ): 226 - 234 .
Chen M , Qiu X , Zhang Q , et al . PSMA uptake on [ 68 Ga]-PSMA-11-PET/CT positively corrects with prostate cancer aggressiveness [J]. Q J Nucl Med Mol Imaging , 2019 Jul 30 . doi: 10.23736/S1824-4785.19.03172-8 http://dx.doi.org/10.23736/S1824-4785.19.03172-8 . Online ahead of print .
赵强 , 刘辰 , 刘佳 , 等 . 68 Ga-PSMA PET-CT检查中SUVmax与前列腺癌患者临床病理特点的相关性分析 [J]. 中华泌尿外科杂志 , 2020 , 41 ( 1 ): 13 - 18 .
Zhao Q , Liu C , Liu J , et al . The relationship between SUVmax on preoperative 68 Ga-PSMA PET-CT and the clinicopathological characteristics in patients treated with radical prostatectomy [J]. Chin J Urol , 2020 , 41 ( 1 ): 13 - 18 .
Leyh-Bannurah SR , Abou-Haidar H , Dell'Oglio P , et al . Primary Gleason pattern upgrading in contemporary patients with D'Amico low-risk prostate cancer: implications for future biomarkers and imaging modalities [J]. BJU Int , 2017 , 119 ( 5 ): 692 - 699 .
Schmidkonz C , Cordes M , Schmidt D , et al . 68 Ga-PSMA-11 PET/CT-derived metabolic parameters for determination of whole-body tumor burden and treatment response in prostate cancer [J]. Eur J Nucl Med Mol Imaging , 2018 , 45 ( 11 ): 1862 - 18723
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