Han Ye, Shen Fan, Jiao Jianhua, Xiao Zunjian, Qin Weijun, Ren Jing, Huan Yi
Department of Radiology, Xijing Hospital, Air Force Medical University, 127 Chang Le West Road, Xi'an, Shaanxi Province, China.
Department of Radiology, 83 Group Military Hospital of People's Liberation Army, Xiangyang Road No.371, Xinxiang, Henan Province, China.
Radiol Med. 2023 May;128(5):520-527. doi: 10.1007/s11547-023-01631-8. Epub 2023 Apr 26.
To explore the relationship between unambiguous radiologic extranodal extension (rENE) and M1 staging in patients with metastatic PCa.
A respective analysis of 1073 patients of PCa N1 staging from January 2004 to May 2022 was retrospectively enrolled. They were divided into rENE + and rENE - groups and retrospectively analyzed the M staging with nuclear medicine data. The correlation index between unambiguous rENE and M1b staging was calculated. Logistic regression was used to evaluate the predictive performance of unambiguous rENE in M1b staging. ROC curves were used to investigate the relationship between unambiguous rENE and M staging in patients who underwent Ga-PSMA PET/CT.
A total of 1073 patients were included. Seven hundred and eighty patients were classified into the rENE + group (mean age, 69.6 years ± 8.7 [standard deviation]), and 293 were classified into rENE - group (mean age, 66.7 years ± 9.4 [standard deviation]). Relationship between unambiguous rENE and M1b existed (r = 0.58, 95%CI: 0.52-0.64, P < 0.05). Unambiguous rENE could be an independent predictor for M1b (OR = 13.64, 95%CI: 9.23-20.14, P < 0.05). The AUC of unambiguous rENE in predicting M1b and M staging was 0.835 and 0.915, respectively, in patients who underwent Ga-PSMA PET/CT.
Unambiguous rENE could be a strong biomarker to predict M1b and M staging in patients with PCa. When rENE came up, patients should perform nuclear medicine immediately, and a systematic treatment should be considered.
探讨转移性前列腺癌患者明确的影像学结外扩展（rENE）与M1分期之间的关系。
回顾性纳入2004年1月至2022年5月期间1073例前列腺癌N1分期患者。将他们分为rENE+组和rENE-组，并利用核医学数据对M分期进行回顾性分析。计算明确的rENE与M1b分期之间的相关指数。采用逻辑回归评估明确的rENE在M1b分期中的预测性能。利用ROC曲线研究接受镓-PSMA PET/CT检查患者中明确的rENE与M分期之间的关系。
共纳入1073例患者。780例患者被分类为rENE+组（平均年龄，69.6岁±8.7[标准差]），293例被分类为rENE-组（平均年龄，66.7岁±9.4[标准差]）。明确的rENE与M1b之间存在相关性（r = 0.58，95%CI：0.52 - 0.64，P < 0.05）。明确的rENE可能是M1b的独立预测因素（OR = 13.64，95%CI：9.23 - 20.14，P < 0.05）。在接受镓-PSMA PET/CT检查的患者中，明确的rENE预测M1b和M分期的AUC分别为0.835和0.915。
明确的rENE可能是预测前列腺癌患者M1b和M分期的有力生物标志物。当出现rENE时，患者应立即进行核医学检查，并考虑进行系统治疗。
