全身磁共振成像联合骨闪烁显像及前列腺特异抗原水平检测前列腺癌转移

Detection of Prostate Cancer Metastasis by Whole Body Magnetic Resonance Imaging Combined with Bone Scintigraphy and PSA Levels.

作者信息

An Hengqing, Tao Ning, Li Jia, Guan Yonghui, Wang Wenguang, Wang Yujie, Wang Feng

机构信息

Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.

出版信息

Cell Physiol Biochem. 2016;40(5):1052-1062. doi: 10.1159/000453161. Epub 2016 Dec 12.

DOI:10.1159/000453161

PMID:27941343

Abstract

BACKGROUND/AIMS: The combined role of whole-body magnetic resonance imaging (WB-MRI), bone scintigraphy and prostate specific antigen (PSA) were considered in predicting metastases and prognosis of prostate cancer (PCa).

METHODS

Totally 38 PCa patients underwent WB-MRI, bone scintigraphy and PSA detections, and 34 benign prostate hyperplasia (BPH) patients were checked with PSA. Pearson correlations were performed to determine associations among PSA, apparent diffusion coefficient (ADC) and Gleason scoring. Specificity and sensitivity were for comparison of diagnostic accuracies. Patients' baseline PSA, PSA nadir and time to the prostate-specific antigen nadir (TTPN) were analyzed, and Kaplan-Meier survival curves were also established.

RESULTS

ADC values were negatively correlated with PSA levels (rs = -0.389, P = 0.016) and Gleason scores (rs = -0.432, P = 0.006), while PSA levels were positively correlated with Gleason scoring (rs = 0.493, P = 0.002). Diagnostic efficacy of whole body-diffusion weighted imaging (WB-DWI) combined with PSA seemed the most favorable, and bone scintigraphy was advantageous in identifying bone metastasis. PSA levels (> 61.60 µg/L), Gleason scores (> 6) and ADC (< 0.81 × 10-3 mm2/s) could all predict pessimistic prognosis (HR = 7.65; HR = 6.09; HR = 7.28). Smaller PSA nadir (≤ 1.0 µg/L) and longer TTPN (> 3 months) were associated with increased 5-year survival rate (P < 0.05).

CONCLUSIONS

The combined efficacies of WB-MRI, bone scintigraphy and PSA levels were desired in identifying PCa lesions and prognosis.

摘要

背景/目的：探讨全身磁共振成像（WB-MRI）、骨闪烁显像和前列腺特异性抗原（PSA）联合应用在预测前列腺癌（PCa）转移及预后中的作用。

方法

共38例PCa患者接受了WB-MRI、骨闪烁显像及PSA检测，34例良性前列腺增生（BPH）患者仅接受了PSA检查。采用Pearson相关性分析确定PSA、表观扩散系数（ADC）和Gleason评分之间的关联。比较诊断准确性的特异性和敏感性。分析患者的基线PSA、PSA最低点及达到前列腺特异性抗原最低点的时间（TTPN），并绘制Kaplan-Meier生存曲线。

结果

ADC值与PSA水平呈负相关（rs = -0.389，P = 0.016），与Gleason评分呈负相关（rs = -0.432，P = 0.006），而PSA水平与Gleason评分呈正相关（rs = 0.493，P = 0.002）。全身弥散加权成像（WB-DWI）联合PSA的诊断效能似乎最佳，骨闪烁显像在识别骨转移方面具有优势。PSA水平（> 61.60 µg/L）、Gleason评分（> 6）和ADC（< 0.81 × 10-3 mm2/s）均可预测预后不良（HR = 7.65；HR = 6.09；HR = 7.28）。较低的PSA最低点（≤ 1.0 µg/L）和较长的TTPN（> 3个月）与5年生存率增加相关（P < 0.05）。