摘要
目的探讨在前列腺癌筛查门诊中引入^(68)Ga-前列腺特异性膜抗原(PSMA)PET/CT的临床价值,分析我院筛查门诊前列腺癌的发病率及穿刺活检情况。方法回顾性分析2021年3—11月在空军军医大学第一附属医院泌尿外科筛查门诊参加前列腺癌筛查人群的资料。采用血清前列腺特异性抗原(PSA)作为筛查指标,对PSA≥4ng/ml者先行mpMRI检查寻找可疑病灶,阳性者再进一步行^(68)Ga-PSMA PET/CT检查确定病灶,勾画穿刺靶点,在超声引导下行系统+靶向穿刺。记录筛查人群的年龄、PSA分布、穿刺检出率,确诊前列腺癌患者的Gleason评分、临床分期等特征。结果筛查共纳入1079例,年龄(63.9±9.9)岁(40~92岁),其中PSA≥4ng/ml者249例(249/1079,23.1%)。249例中,87例(87/249,34.9%)接受mpMRI检查,34例(34/249,13.7%)前列腺影像报告和数据系统(PI-RADS)评分≥3分。此34例mpMRI有可疑病灶者均进一步行^(68)Ga-PSMA PET/CT扫描,11例(11/249,4.4%)PSMA核素异常摄取。共有32例(12例仅PSA异常,20例影像学阳性)患者最终接受前列腺穿刺活检,确诊前列腺癌11例,阳性检出率为34.4%(11/32),占筛查人群的1.0%(11/1079)。其中20例影像学阳性(9例仅mpMRI阳性,11例mpMRI、^(68)Ga-PSMA PET/CT均阳性)患者进行系统+靶向融合穿刺活检,检出前列腺癌阳性率45%(9/20)。12例仅PSA异常者接受常规系统穿刺活检,阳性检出率为16.7%(2/12),两组差异有统计学意义(P<0.05)。11例确诊前列腺癌患者中,Gleason评分<7分3例(27.3%),≥7分8例(72.7%);局限性前列腺癌(≤T_(2)期)5例(45.4%),局部进展期(T_(3)~T_(4)期)前列腺癌2例(18.2%);转移性前列腺癌4例(36.4%),其中3例全身多发骨转移,1例骨转移伴远处淋巴结转移。11例确诊患者中10例(90.9%)为有临床意义前列腺癌;在7例局限性和局部进展期前列腺癌患者中,高危5例(71.4%)。结论前列腺癌筛查中,如在常规mpMRI基础上引入^(68)Ga-PSMA PET/CT检查,可以提高有临床意�
Objective To explore the clinical value of introducing^(68)Ga PSMA PET/CT into the prostate cancer(PCa)screening clinic,and to analyze the incidence rate and biopsy of PCa in the screening clinic of our hospital.Methods The data of the people who participated in PCa screening in the urology screening clinic of our hospital from March 2021 to November 2021 were retrospectively analyzed.Serum PSA was used as the screening index.The subjects with PSA≥4ng/ml were first examined by mpMRI to find suspicious nodules,and the positive ones were further examined by^(68)Ga-PSMA PET/CT to determine the lesions.The puncture target was outlined,and systematic+targeted puncture was conducted under ultrasound guidance.The age,PSA distribution,puncture detection rate,Gleason score and clinical stage of patients with PCa were recorded.Results A total of 1079 subjects were included in the screening,with an average age of(63.9±9.9)(ranging 40-92)years old,and 249 patients(23.1%,249/1079)with PSA≥4ng/ml.Among them,87 cases(87/249,34.9%)received mpMRI,and 34 cases(34/249,13.7%)had PI-RADS score≥3 points.These 34 patients with suspected nodules on MRI were further scanned with^(68)Ga-PSMA PET/CT,and 11 cases(11/249,4.4%)had abnormal uptake of PSMA nuclide.A total of 32 patients(12 patients with PSA abnormalities and 20 patients with positive imaging)finally received prostate biopsy,and 11 patients were diagnosed with PCa,with a positive detection rate of 34.4%(11/32),accounting for 1.0%(11/1079)of the screening population.Among them,20 patients with positive imaging(9 patients with only mpMRI positive and 11 patients with both mpMRI and^(68)Ga-PSMA PET/CT positive)underwent system+targeted fusion biopsy,and the positive rate was 45%(9/20).12 patients(only PSA abnormal)underwent routine systematic puncture biopsy,and the positive detection rate was 16.7%(2/12).The difference between the two groups was statistically significant(P<0.05).Among the patients with confirmed PCa,27.3%(3/11)had Gleason score less than 7,and 72.7%(8/11)ha
作者
武鹏
田春娟
马帅军
张景良
焦健华
张静
任静
康飞
杨晓剑
秦卫军
Wu Peng;Tian Chunjuan;Ma Shuaijun;Zhang Jingliang;Jiao Jianhua;Zhang Jing;Ren Jing;Kang Fei;Yang Xiaojian;Qin Weijun(Department of Urology,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,China;Department of Pathology,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,China;Department of Radiology,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,China;Department of Nuclear Medicine,First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2022年第7期495-499,共5页
Chinese Journal of Urology
关键词
前列腺肿瘤
癌
前列腺特异性膜抗原
筛查
前列腺穿刺
Prostatic neoplasms
Carcinoma
Prostate-specific membrane antigens
Screening
Prostate puncture
