在初诊前列腺癌中 Ga-PSMA PET/CT 检测到的骨转移的特征。

Characterization of bone metastases detected on Ga-PSMA PET/CT in newly diagnosed prostate cancer.

机构信息

Selcuk University, Faculty of Medicine, Department of Nuclear Medicine, Ardıçlı, Akademi, Celal Bayar St. No: 313, PC: 42250 Selcuklu/Konya Turkey.

出版信息

Hell J Nucl Med. 2022 Jan-Apr;25(1):57-62. doi: 10.1967/s002449912443.

DOI:10.1967/s002449912443

PMID:35503556

Abstract

OBJECTIVE

This study sought to investigate the characteristics of bone metastasis (BM) and the association of BM with clinicopathological factors in prostate cancer (PCa) patients presenting with BM on the initial staging gallium-68-prostate-specific membrane antigen (Ga-PSMA) positron emission tomography/computed tomography (PET/CT).

MATERIALS AND METHODS

Patients with at least one BM in the initial staging Ga-PSMA PET/CT between January 2018 and December 2021 were reviewed retrospectively. Types of BM were classified according to Ga-PSMA PET/CT findings as osteoblastic (OB), osteolytic (OL), intramedullary (IM) and coexistence of these types. Patients were divided into two groups according to the number of BM: Oligo-BM for those with five or fewer BMs and poly-BM for those with more than five BM. Receiver-operating characteristic (ROC) curves were generated for serum bone-specific alkaline phosphatase (ALP) and prostate-specific antigen (PSA) levels to discriminate between oligo-BM and poly-BM groups. Univariate and multivariate logistic regression tests were performed to find independent predictors of poly-BM.

RESULTS

A total of 53 patients with a median age of 70 (range: 49-88) were included in the study. The median Gleason score of the patients was 8 (range: 6-10). Among the patients, 23 had solely OB-type; 10 had solely IM type; 12 had OB and IM type; four had IM and OL type, two had OB and OL type; one had solely OL type, and one had IM and OB and OL type BM. Oligo-BM was detected in 25 patients (47.2%) and poly-BM was detected in 28 patients (52.8%). In multivariate analyses, serum ALP levels ≥122U/L and PSA levels ≥85.4ng/mL were found to be independent predictors of poly-BM.

CONCLUSION

In characterizing BM of PCa, we found that OB-type metastases were the most common type, followed by IM-type and OL-type metastases, respectively. High ALP and PSA levels were found to be independent predictors of poly-BM.

摘要

目的

本研究旨在探讨初诊 Ga-68-前列腺特异性膜抗原（Ga-PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）时发生骨转移（BM）的前列腺癌（PCa）患者的 BM 特征及其与 BM 的临床病理因素的相关性。

材料和方法

回顾性分析了 2018 年 1 月至 2021 年 12 月期间在初诊 Ga-PSMA PET/CT 中至少有一个 BM 的患者。根据 Ga-PSMA PET/CT 结果，将 BM 类型分为成骨型（OB）、溶骨型（OL）、骨髓内型（IM）和这些类型共存。根据 BM 数量将患者分为两组：BM 少于等于 5 个为寡 BM，多于 5 个为多 BM。绘制血清骨特异性碱性磷酸酶（ALP）和前列腺特异性抗原（PSA）水平的受试者工作特征（ROC）曲线，以区分寡 BM 和多 BM 组。进行单变量和多变量逻辑回归检验，以寻找多 BM 的独立预测因素。

结果

共纳入 53 例患者，中位年龄为 70 岁（范围：49-88 岁）。患者中位 Gleason 评分为 8 分（范围：6-10 分）。其中，23 例患者仅为 OB 型；10 例患者仅为 IM 型；12 例患者为 OB 和 IM 型；4 例患者为 IM 和 OL 型，2 例患者为 OB 和 OL 型，1 例患者为单纯 OL 型，1 例患者为 IM、OB 和 OL 型 BM。25 例患者（47.2%）为寡 BM，28 例患者（52.8%）为多 BM。多变量分析发现，血清 ALP 水平≥122U/L 和 PSA 水平≥85.4ng/mL 是多 BM 的独立预测因素。