68Ga-PSMA PET-CT术前SUVmax与前列腺癌根治术患者临床病理特征的关系

Q4 Medicine
Qiang Zhao, Chen Liu, Jia Liu, Xingxing Tang, Yongpeng Ji, Yudong Cao, B. Hong, Te-li Liu, Zhi Yang, D. Peng, Yong Yang, Ning Zhang
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Baseline testosterone of 14 patients was (4.72±1.64)ng/ml.Based on the Gleason scores related ISUP classification, all patients were classified into grade one in 5 cases, grade 2in 7 cases, grade 3 in 4 cases, grade 4 in 10 cases and grade 5 in 5 cases. The clinical classification included 6 cases in T2a stage, 2 cases in T2b stage, 17 cases in T2c stage, 1 case in T3a stage, 4 cases in T3b stage and 1 case in T4 stage. SUVmax was accessed by two independent professional nuclear medicine physicians. SUVmax was 12.49±9.38. SPSS 16.0 software was used to do statistic analysis. \n \n \nResults \nThe post-operative pathological results showed the surgical margin positive in 19 cases, negative in 12 cases, vascular positive in 5 cases, negative in 20 case, positive nerve invasion in 20 cases and negative in 11 cases. 2 patients were low risk, 7 patients were medium risk and 22 patients were high risk according to D′Amico classification. Based on the basis of PSA(≤10 or>10) and Gleason score(≤6 or>6), 6 patients were in group with low PSA and low Gleason score, 5 patients were low PSA and high Gleason score, 9 patients were high PSA and low Gleason score, 11 patients were high PSA and high Gleason score. SUVmax had a significant positive relationship with pathological ISUP(r=0.434, P=0.015) and SUVmax in patients with positive intravascular tumor emboli was significantly higher than those with negative intravascular tumor emboli(14.78±10.68 vs. 8.17±2.81, P=0.005). No significant correlation was found between SUVmax and baseline PSA, testosterone, pathologic T stage, surgical margin, nerve invasion, pelvic lymph node status as well as risk stratification. SUVmax could distinguish pathologic ISUP grade 5 with a maximum AUC 0.747 (P=0.033) and the sensitivity was 88.9%. The specificity was 77.3% when SUVmax≥11.34. 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引用次数: 0

摘要

目的探讨68Ga-PSMA PET-CT术前SUVmax与前列腺癌根治术患者临床病理特征的关系。方法回顾性分析2016年5月至2019年8月期间术前接受68Ga-PSMA PET-CT评估并接受根治性前列腺切除术的患者的临床病理数据。31名患者的平均年龄(63.1±4.9)和基线PSA(72.71±173.15)ng/ml。他们的BMI平均值为(24.6±3.0)kg/m2。14例患者的基线睾酮水平为(4.72±1.64)ng/ml。根据Gleason评分相关的ISUP分类,所有患者分为1级5例、2级7例、3级4例、4级10例和5级5例。临床分型为T2a期6例,T2b期2例,T2c期17例,T3a期1例,T3b期4例,T4期1例。两名独立的专业核医学医生访问了SUVmax。SUVmax为12.49±9.38。采用SPSS 16.0软件进行统计分析。结果术后病理结果:手术切缘阳性19例,阴性12例,血管阳性5例,阴性20例,神经侵犯阳性20例,阴性11例。根据D′Amico分类,2例为低危,7例为中危,22例为高危。根据PSA(≤10或>10)和Gleason评分(≤6或>6),6例患者为低PSA低Gleason分组,5例为低PSA高Gleason得分组,9例为高PSA低Gleeson得分组。SUVmax与病理性ISUP呈显著正相关(r=0.434,P=0.015),血管内肿瘤栓塞阳性患者的SUVmax显著高于血管内肿瘤阴性患者(14.78±10.68 vs.8.17±2.81,P=0.005),神经侵犯、盆腔淋巴结状况以及风险分层。SUVmax可区分病理性ISUP 5级,最大AUC为0.747(P=0.033),敏感性为88.9%,当SUVmax≥11.34时,特异性为77.3%。结论术前68Ga PSMA PET-CT测量的SUVmax对预测根治性前列腺切除术患者的不良病理因素具有临床意义。关键词:前列腺肿瘤;前列腺癌症;前列腺特异性膜抗原(PSMA);68Ga;正电子发射断层扫描(PET-CT);最大标准化摄取值(SUVmax);格里森得分
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The relationship between SUVmax on preoperative 68Ga-PSMA PET-CT and the clinicopahtological characteristics in patients treated with radical prostatectomy
Objective To investigate the relationship between SUVmax on preoperative 68Ga-PSMA PET-CT and the clinicopathological characteristics of patients treated with radical prostatectomy. Methods The clinicopahtological data of patients evaluated with 68Ga-PSMA PET-CT preoperatively and treated with radical prostatectomy between May 2016 and August 2019 were retrospectively reviewed. 31 patients with a mean age (63.1±4.9) and baseline PSA (72.71±173.15)ng/ml were enrolled. Their BMI mean (24.6±3.0)kg/m2. Baseline testosterone of 14 patients was (4.72±1.64)ng/ml.Based on the Gleason scores related ISUP classification, all patients were classified into grade one in 5 cases, grade 2in 7 cases, grade 3 in 4 cases, grade 4 in 10 cases and grade 5 in 5 cases. The clinical classification included 6 cases in T2a stage, 2 cases in T2b stage, 17 cases in T2c stage, 1 case in T3a stage, 4 cases in T3b stage and 1 case in T4 stage. SUVmax was accessed by two independent professional nuclear medicine physicians. SUVmax was 12.49±9.38. SPSS 16.0 software was used to do statistic analysis. Results The post-operative pathological results showed the surgical margin positive in 19 cases, negative in 12 cases, vascular positive in 5 cases, negative in 20 case, positive nerve invasion in 20 cases and negative in 11 cases. 2 patients were low risk, 7 patients were medium risk and 22 patients were high risk according to D′Amico classification. Based on the basis of PSA(≤10 or>10) and Gleason score(≤6 or>6), 6 patients were in group with low PSA and low Gleason score, 5 patients were low PSA and high Gleason score, 9 patients were high PSA and low Gleason score, 11 patients were high PSA and high Gleason score. SUVmax had a significant positive relationship with pathological ISUP(r=0.434, P=0.015) and SUVmax in patients with positive intravascular tumor emboli was significantly higher than those with negative intravascular tumor emboli(14.78±10.68 vs. 8.17±2.81, P=0.005). No significant correlation was found between SUVmax and baseline PSA, testosterone, pathologic T stage, surgical margin, nerve invasion, pelvic lymph node status as well as risk stratification. SUVmax could distinguish pathologic ISUP grade 5 with a maximum AUC 0.747 (P=0.033) and the sensitivity was 88.9%. The specificity was 77.3% when SUVmax≥11.34. SUVmax in patients with upgrading ISUP was significantly higher than that in patients with downgrading ISUP (16.01±5.40 vs. 4.98±2.11, P=0.007). Conclusions SUVmax measured on preoperative 68Ga-PSMA PET-CT may have a clinical significance in predicting unfavorable pathological factors for patients treated with radical prostatectomy. Key words: Prostatic neoplasms; Prostate cancer; Prostate-specific membrane antigen(PSMA); 68Ga; Positron-emission tomography(PET-CT); Maximum standardized uptake value(SUVmax); Gleason score
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来源期刊
中华泌尿外科杂志
中华泌尿外科杂志 Medicine-Nephrology
CiteScore
0.10
自引率
0.00%
发文量
14180
期刊介绍: Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.
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