Real Nuclear Real Hospital Português de Beneficência em Pernambuco, Av. Gov. Agamenon Magalhães, 4760, Paissandu, Recife, PE, 52010-902, Brazil.
Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, Brazil.
Ann Nucl Med. 2019 May;33(5):344-350. doi: 10.1007/s12149-019-01342-z. Epub 2019 Feb 11.
68 Ga-PSMA-PET has an increasing importance in the evaluation of prostate cancer patients due to its high sensitivity and specificity in identifying neoplastic lesions in the clinical setting of elevated prostate-specific antigen (PSA). The objective of this study was to calculate the whole-body tumor burden using volumetric quantification of lesions detected in Ga-PSMA-PET of prostate cancer patients with biochemical recurrence and correlate these findings with clinical and image parameters.
Each patient had their Ga-PSMA-PET analyzed for the presence of neoplastic lesions. Their PSA levels and clinical information were recorded. In positive cases, the tumor burden (TL-PSMA) was calculated with a semi-automatic software and manually, and the results are analyzed and tested.
We analyzed 100 prostate cancer patients, mean age of 69.9 ± 9.7 years and a median PSA of 1.73 ng/dL. Ga-PSMA-PET identified neoplastic lesions in 72% of them. The median TL-PSMA was 55.95 ml (1.1-28,080 ml). TL-PSMA and PSA were strongly correlated (rho = 0.71, p < 0.0001, 95% CI 0.60-0.80). TL-PSMA and PSA levels groups had a significant correlation and TL-PSMA and Gleason score were independent variables associated with PSA levels (p < 0.05).
TL-PSMA strongly and independently correlates with PSA levels in prostate cancer patients and could be used as a biomarker to separate them into groups with high or low tumor burden, instead of considering only the number of lesions.
由于 68Ga-PSMA-PET 在识别临床前列腺特异性抗原（PSA）升高患者的肿瘤病变方面具有较高的灵敏度和特异性，因此在评估前列腺癌患者方面的重要性日益增加。本研究旨在通过对生化复发的前列腺癌患者 Ga-PSMA-PET 检测到的病变进行容积定量来计算全身肿瘤负担，并将这些发现与临床和影像学参数相关联。
每位患者的 Ga-PSMA-PET 均进行了分析，以确定是否存在肿瘤病变。记录了他们的 PSA 水平和临床信息。在阳性病例中，使用半自动软件和手动计算肿瘤负担（TL-PSMA），并对结果进行分析和测试。
我们分析了 100 例前列腺癌患者，平均年龄为 69.9±9.7 岁，中位 PSA 为 1.73ng/dL。Ga-PSMA-PET 在其中 72%的患者中发现了肿瘤病变。TL-PSMA 的中位数为 55.95ml（1.1-28,080ml）。TL-PSMA 和 PSA 呈强相关（rho=0.71，p<0.0001，95%CI 0.60-0.80）。TL-PSMA 和 PSA 水平组之间存在显著相关性，TL-PSMA 和 Gleason 评分是与 PSA 水平相关的独立变量（p<0.05）。
TL-PSMA 与前列腺癌患者的 PSA 水平呈强独立相关，可作为生物标志物将其分为高肿瘤负担和低肿瘤负担组，而不仅仅考虑病变数量。
