18F-PSMA-1007 PET/CT联合临床指标可有效预测前列腺癌不同转移状态OA
Combined use of 18F-PSMA-1007 PET/CT and clinical indicators effectively predicts different metastatic states in prostate cancer
目的 探讨前列腺癌不同转移阶段(未转移、寡转移、多发转移)与¹⁸F-前列腺特异性膜抗原(PSMA)-1007 PET/CT显像特征及临床参数的关系.方法 回顾性收集2022年2月～2025年5月在新疆医科大学第一附属医院行18F-PSMA-1007 PET/CT检查并经病理确诊为前列腺癌的269例患者.依据显像结果将患者分为未转移组(n=107)、寡转移组(n=60)、多发转移组(n=102),比较3组间的影像学及临床参数,将单因素分析有统计学意义的参数纳入多元logistic回归分析,绘制ROC曲线,评估危险因素对多发转移的预测效能.结果 单因素分析表明,总前列腺特异性抗原(TPSA)、前列腺特异性抗原密度、游离前列腺特异性抗原(FPSA)、游离前列腺特异性抗原与总前列腺特异性抗原比值(F/T)、格里森评分、国际泌尿病理协会(ISUP)低分级(ISUP 1～3级)和高分级(ISUP 4～5级)、肿瘤背景比值、最大标准化摄取值(SUVmax)、平均标准化摄取值(SUVmean)、总病变糖酵解(TLG)、肿瘤代谢体积(MTV)及前列腺体积(PV)在3组间差异有统计学意义(P<0.05).多元无序logistic回归结果表明FPSA、ISUP分级是前列腺癌寡转移的独立影响因素(P<0.05);SUVmean、MTV、TPSA、PV、ISUP分级是前列腺癌多发转移的独立影响因素(P<0.05).TPSA、SUVmean、MTV及PV诊断前列腺癌多发转移的ROC曲线结果显示,TPSA诊断效能最高(AUC=0.878,特异度90.4%),SUVmean敏感度最佳(94.1%),MTV及PV的AUC值、敏感度及特异度均低于TPSA及SUVmean,且MTV及PV的上述指标无差异.结论 ¹⁸F-PSMA-1007 PET/CT代谢参数与临床指标联合可较好地区分前列腺癌转移状态,FPSA、ISUP分级是前列腺寡转移的独立影响因素,而TPSA、SUVmean、MTV、PV、ISUP是前列腺多发转移的独立影响因素.
Objective To evaluate the relationship between distinct metastatic stages(non-metastatic,oligometastatic,and polymetastatic)of prostate cancer and 18F-prostate-specific membrane antigen(PSMA)-1007 PET/CT imaging characteristics together with clinical parameters.Methods A retrospective analysis was conducted on 269 pathologically confirmed prostate cancer patients who underwent 18F-PSMA-1007 PET/CT at the First Affiliated Hospital of Xinjiang Medical University from February 2022 to May 2025.Based on imaging findings,patients were categorized into non-metastatic(n=107),oligometastatic(n=60),and polymetastatic(n=102)groups.Comparative analysis of clinical and imaging parameters among groups was performed.Variables significant on univariate analysis were entered into multivariable logistic regression.ROC curves were constructed to evaluate the discriminative performance of risk factors for polymetastasis.Results Univariate analysis demonstrated significant differences(P<0.05)among groups in total prostate-specific antigen(TPSA),prostate-specific antigen density,free PSA(FPSA),the FPSA/TPSA ratio,Gleason score,International Society of Urological Pathology(ISUP)grading(low grade:1-3;high grade:4-5),tumor-to-background ratio(TBR),maximum standardized uptake value(SUVmax),mean SUV(SUVmean),total lesion glycolysis,metabolic tumor volume(MTV),and prostate volume(PV).Multivariable logistic regression revealed FPSA and ISUP as independent predictors of oligometastasis(P<0.05),while SUVmean,MTV,TPSA,PV,and ISUP were independent predictors of polymetastasis(P<0.05).ROC analysis indicated that TPSA achieved the highest diagnostic accuracy for polymetastasis(AUC=0.88,specificity=90.4%),whereas SUVmean demonstrated the highest sensitivity(94.1%).MTV and PV showed lower AUCs,sensitivity,and specificity compared with TPSA and SUVmean,with no significant differences between the MTV and PV metrics.Conclusion Integrating 18F-PSMA-1007 PET/CT metabolic parameters with clinical indicators enhances stratification of metastatic burden in prostate cancer.FPSA and ISUP are independent predictors of oligometastasis,while TPSA,SUVmean,MTV,PV,and ISUP serve as independent determinants of polymetastasis.
张文仙;李肖红;张奇洲;李毓斌;赵晓佳
新疆医科大学第一附属医院核医学科,新疆 乌鲁木齐 830054新疆医科大学第一附属医院核医学科,新疆 乌鲁木齐 830054新疆医科大学第一附属医院核医学科,新疆 乌鲁木齐 830054新疆医科大学第一附属医院核医学科,新疆 乌鲁木齐 830054新疆医科大学第一附属医院核医学科,新疆 乌鲁木齐 830054
前列腺癌寡转移危险因素
prostate canceroligometastasisrisk factors
《分子影像学杂志》 2026 (1)
50-55,6
新疆维吾尔自治区自然科学基金(2019D01C307)
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