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锝-99m-亚甲基二膦酸盐单光子发射计算机断层扫描/计算机断层扫描联合前列腺特异性抗原/游离前列腺特异性抗原比值用于前列腺癌骨转移的诊断

Technetium-99m-methylene diphosphonate single photon emission computed tomography/computed tomography combined with prostate-specific antigen/free prostate-specific antigen ratio for bone metastasis of prostate cancer.

作者信息

He Jian, Zhong Yi-Pu, Zhang Shuang

机构信息

Department of Nuclear Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China.

Department of Nuclear Medicine, The People's Hospital of Jianyang, Jianyang 641400, Sichuan Province, China.

出版信息

World J Clin Cases. 2024 Jul 16;12(20):4082-4090. doi: 10.12998/wjcc.v12.i20.4082.

Abstract

BACKGROUND

Prostate cancer (PC) is one of the most common malignant tumors in men, and bone metastasis is one of its common complications, which seriously affects the quality of life and prognosis of patients.

AIM

To investigate the diagnostic value of technetium-99m-methylene diphosphonate (99mTc-MDP) single photon emission computed tomography (SPECT)/CT imaging combined with the serum prostate-specific antigen (PSA)/free PSA ratio for PC bone metastasis (PCBM).

METHODS

One hundred patients with PC who visited the Hospital of Chengdu University of Traditional Chinese Medicine from January 2020 to January 2022 were recruited as the experimental (Exp) group, while 30 patients with benign prostatic lesions (BPLs) were recruited as the control (Ctrl) group. All patients underwent 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA testing. The SPECT/CT imaging results and serum PSA/fPSA ratios of patients were analyzed to evaluate their diagnostic values for PCBM.

RESULTS

The difference in general information of the patients was not obvious, showing comparability. The two methods showed no visible differences in negative predictive value and sensitivity for patients with PCBM, but had great differences in positive predictive value and specificity ( < 0.05). The PSA/fPSA ratio of patients with PC in the Exp group was lower than those with BPLs, and patients with PCBM had a much lower PSA/fPSA ratio than those without PC ( < 0.05). The results confirmed that the combined use of 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA ratio achieved a detection rate of 95% for PCBM.

CONCLUSION

The combination of 99mTc-MDP SPECT/CT and PSA/fPSA ratio is accurate and reliable for the diagnosis of PCBM, which provides an important reference for clinical practice.

摘要

背景

前列腺癌(PC)是男性最常见的恶性肿瘤之一,骨转移是其常见并发症之一,严重影响患者的生活质量和预后。

目的

探讨99m锝-亚甲基二膦酸盐(99mTc-MDP)单光子发射计算机断层扫描(SPECT)/CT成像联合血清前列腺特异性抗原(PSA)/游离PSA比值对前列腺癌骨转移(PCBM)的诊断价值。

方法

选取2020年1月至2022年1月在成都中医药大学附属医院就诊的100例PC患者作为试验(Exp)组,选取30例良性前列腺病变(BPL)患者作为对照(Ctrl)组。所有患者均接受99mTc-MDP SPECT/CT成像及血清PSA/fPSA检测。分析患者的SPECT/CT成像结果及血清PSA/fPSA比值,评估其对PCBM的诊断价值。

结果

患者一般资料差异不明显,具有可比性。两种方法对PCBM患者的阴性预测值和敏感性无明显差异,但在阳性预测值和特异性方面差异有统计学意义(<0.05)。Exp组PC患者的PSA/fPSA比值低于BPL患者,PCBM患者的PSA/fPSA比值远低于无PC患者(<0.05)。结果证实,99mTc-MDP SPECT/CT成像与血清PSA/fPSA比值联合应用对PCBM的检出率为95%。

结论

99mTc-MDP SPECT/CT与PSA/fPSA比值联合应用对PCBM的诊断准确可靠,为临床实践提供了重要参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5428/11235539/55a36d83db3d/WJCC-12-4082-g001.jpg

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