摘要
目的:进一步提高前列腺癌转移灶的诊断以及治疗水平。方法:收集2015~2016年我院收治并接受前列腺特异性膜抗原(PSMA)-单光子发射计算机断层摄影术联合同机CT扫描图像融合技术(SPECT/CT)检查的前列腺癌患者,对其中3例典型患者的临床资料进行回顾性分析。结果:病例1予以内分泌治疗后,PSA控制效果不佳,PSMA-SPECT/CT明确右盆腔淋巴结转移病灶后行前列腺癌根治术+盆腔扩大淋巴结清扫术,术后病理结果同影像学检查效果一致,术后PSA明显下降。病例2行前列腺癌根治术后,PSA控制效果不佳,加用盆腔放疗后未见明显降低,PSMA-SPECT/CT示腹膜后淋巴结转移,遂行腹膜后淋巴结清扫术,术后病理结果同PSMA-SPECT/CT检查结果一致,术后PSA水平下降。病例3行前列腺根治术后,PSA控制不佳,PSMASPECT/CT示右髂内淋巴结转移,根据PSMA-SPECT/CT行靶病灶放疗,PSA水平明显下降。结论:该研究提示99mTC-PSMA-SPECT/CT与目前影像学检查比较,能够更好地发现前列腺癌转移灶,且精准指导靶病灶治疗,进而使患者获益。
Objective：To improve the diagnosis and treatment for metastatic lesions of patients with prostate cancer.Method：The clinical data of three typical cases with prostate cancer from 2015 to 2016who received PSMA-SPECT/CT were analyzed in our hospital.Result：The prostate specific antigen（PSA）control in case 1was not satisfactory after androgen deprivation therapy（ADT）.PSMA-SPECT/CT showed suspicious lymph node metastases near to right iliac blood vessels,so this patient received radical prostatectomy（RP）and extended pelvic lymphadenectomy.The pathological results were consistent with PSMA-SPECT and PSA level decreased obviously.The PSA control in case 2was not satisfactory with radiation treatment after RP.This patient received retroperitoneal lymph node dissection（RPLND）when PSMA-SPECT/CT showed suspicious lymph node metastases near to retroperitoneal lymph node.Also,the pathological results were consistent with PSMA-SPECT and PSA level decreased.The PSA control in case 3was not satisfactory after RP.PSMA-SPECT/CT showed suspicious lymph node metastases near to right iliac blood vessels and this patient received previse radiation and PSA level decreased obviously.Conclusion：Compared to currently commonly used imaging examination for patients with prostate cancer,99mTC-PSMA-SPECT/CT could detect metastatic lesions more efficiently and help to guide previse treatment for these patients.
作者
宿恒川
朱耀
胡四龙
戴波
叶定伟
SU Hengchuan ZHU Yao HU Silong DAI Bo YE Dingwei(Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032 Department of Nuclear Medicine, Fudan University Shanghai Cancer Center)
出处
《临床泌尿外科杂志》
2017年第3期189-191,共3页
Journal of Clinical Urology
基金
国家自然科学基金(编号81602222
81472377)
