Gühne Falk, Seifert Philipp, Theis Bernhard, Steinert Matthias, Freesmeyer Martin, Drescher Robert
Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany.
Pathology Division, Institute of Forensic Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany.
Diagnostics (Basel). 2021 Jun 23;11(7):1142. doi: 10.3390/diagnostics11071142.
PET/CT with prostate-specific membrane antigen (PSMA)-targeted tracers has been used in the diagnosis and staging of patients with clear cell renal cell carcinoma (ccRCC). For ccRCC primary tumors, PET parameters were shown to predict histologic grade and features. The aim of this study was to correlate PSMA PET/CT with histopathological findings in patients with metastatic recurrence of ccRCC. Patients with ccRCC who underwent PSMA-targeted PET/CT and subsequent histopathological evaluation of suspicious lesions were included. Specimens underwent immunohistochemical marking. Lesion diameter, volume and tracer uptake were correlated with the extent and intensity of molecular PSMA expression and with clinical findings. Twelve PET-positive lesions of nine patients were evaluated. Eleven ccRCC metastases and one prostate carcinoma were detected histopathologically. Molecular PSMA expression was detected in all lesions, which intensity and distribution did not correlate with PET parameters. PSMA-targeted PET/CT is a feasible tool for the evaluation of patients with ccRCC but cannot reliably predict histologic features of metastases. PSMA may also be expressed in malignant lesions other than ccRCC, leading to incidental detection of these tumors.
使用前列腺特异性膜抗原（PSMA）靶向示踪剂的PET/CT已用于透明细胞肾细胞癌（ccRCC）患者的诊断和分期。对于ccRCC原发性肿瘤，PET参数显示可预测组织学分级和特征。本研究的目的是将PSMA PET/CT与ccRCC转移复发患者的组织病理学结果相关联。纳入接受PSMA靶向PET/CT及随后对可疑病变进行组织病理学评估的ccRCC患者。标本进行免疫组化标记。病变直径、体积和示踪剂摄取与分子PSMA表达的程度和强度以及临床结果相关。对9例患者的12个PET阳性病变进行了评估。组织病理学检测到11个ccRCC转移灶和1例前列腺癌。所有病变均检测到分子PSMA表达，其强度和分布与PET参数无关。PSMA靶向PET/CT是评估ccRCC患者的一种可行工具，但不能可靠地预测转移灶的组织学特征。PSMA也可能在ccRCC以外的恶性病变中表达，导致这些肿瘤的偶然发现。
