Department of Nuclear Medicine, School of Medicine, Tokat Gaziosmanpasa University, 60250 Tokat, Turkey.
Department of Nuclear Medicine, School of Medicine, Sivas Cumhuriyet University, 58140 Sivas, Turkey.
Curr Oncol. 2024 Sep 8;31(9):5307-5317. doi: 10.3390/curroncol31090391.
This study aimed to evaluate the relationship between pathological and clinical risk classifications in newly diagnosed prostate cancer patients, and Ga-PSMA PET/CT data and serum Prostate Specific Antigen (PSA) values.
A total of 203 patients who were diagnosed with prostate cancer between 2019 and 2023, who had not yet received treatment and who underwent Ga-PSMA PET/CT for staging purposes were included in this study.
There was a substantial correlation between D'Amico risk classification, Gleason score, ISUP classification, and the presence or absence of metastasis ( < 0.0001). The median SUVmax value of the prostate gland and the D'Amico risk classification were statistically significantly correlated. ( < 0.0001). There was a statistically significant correlation between the ISUP classification and the PSA value and prostate gland SUVmax value ( < 0.0001). There was a significant correlation between the median SUVmax values of the prostate gland at the time of diagnosis and the patients with and without metastases ( < 0.0001). According to the data obtained from ROC analysis, patients with prostate gland SUVmax values of 8.75 and above were found to have a high probability of metastasis with a sensitivity of 78.9% and a specificity of 59.05%.
Our study showed that Ga-PSMA PET/CT is a highly effective method for staging newly diagnosed high-risk prostate cancer. The probability of metastasis was found to be dramatically increased in Gleason 8 and above. According to D'Amico risk classification, metastasis was detected in at least half of high-risk patients. Since the sensitivity of metastasis was 78.9% in patients with prostate gland SUVmax value above 8.75, we think that these patients should be carefully reported in terms of metastasis.
本研究旨在评估新诊断前列腺癌患者的病理和临床风险分类与 Ga-PSMA PET/CT 数据及血清前列腺特异性抗原（PSA）值之间的关系。
共纳入 203 例 2019 年至 2023 年间诊断为前列腺癌、尚未接受治疗且因分期目的而行 Ga-PSMA PET/CT 的患者。
D'Amico 风险分类、Gleason 评分、ISUP 分级和是否存在转移之间存在显著相关性（<0.0001）。前列腺的中位 SUVmax 值与 D'Amico 风险分类呈显著相关（<0.0001）。ISUP 分级与 PSA 值和前列腺 SUVmax 值之间存在显著相关性（<0.0001）。诊断时前列腺 SUVmax 值的中位数与有和无转移的患者之间存在显著相关性（<0.0001）。根据 ROC 分析获得的数据，前列腺 SUVmax 值为 8.75 及以上的患者发生转移的概率较高，其灵敏度为 78.9%，特异性为 59.05%。
本研究表明，Ga-PSMA PET/CT 是一种对新诊断的高危前列腺癌进行分期的高效方法。Gleason 8 及以上患者的转移概率显著增加。根据 D'Amico 风险分类，高危患者中至少有一半发生了转移。由于前列腺 SUVmax 值大于 8.75 的患者发生转移的灵敏度为 78.9%，我们认为这些患者在发生转移方面应仔细报告。
