CXCR4 PET/CT成像在单侧原发性醛固酮增多症患者肾上腺切除术后的预后价值。
The prognostic value of CXCR4 PET/CT imaging in unilateral primary aldosteronism patients after adrenalectomy.
作者信息
Shao Shuai, Xu Haozhe, Xing Zhuo, Hong Yulong, Yin Xuan, Luo Jianguang, Ai Kai, Su Xin, Ma Xiaowei, Li Yuan
机构信息
Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
出版信息
EJNMMI Res. 2025 Apr 17;15(1):41. doi: 10.1186/s13550-025-01242-6.
BACKGROUND
CXCR4 PET/CT imaging has emerged as a tool for diagnosis and subtyping of primary aldosteronism (PA). But its prognostic value for postoperative blood pressure recovery has not been fully discussed.
RESULTS
The lesional SUVmax to the contralateral adrenal tissue SUVmean ratio (LCR) was identified as an independent predictor of clinical success at both the 3-month and 6-month assessments. The AUC for LCR was 0.894 at the 3-month and 0.832 at the 6-month. Patients were divided into high and low LCR groups according to the optimal cut-off of 3.240. The high LCR group exhibited elevated CXCR4 and CYP11B2 expression, higher PAC level, a greater probability of achieving complete clinical success compared to the low LCR group. Moreover, LCR was correlated with lateralization index and contralateral suppression index.
CONCLUSIONS
LCR is a reliable independent predictor of postoperative blood pressure recovery in PA. Patients with LCR over 3.240 may benefit more from adrenalectomy. We recommend increased utilization of CXCR4 PET/CT for patients with PA.
REGISTRATION
ChiCTR2200062844. Registered 20 August 2022.
背景
CXCR4正电子发射断层扫描/计算机断层扫描（PET/CT）成像已成为原发性醛固酮增多症（PA）诊断和亚型分类的一种工具。但其对术后血压恢复的预后价值尚未得到充分探讨。
结果
病变部位的最大标准摄取值（SUVmax）与对侧肾上腺组织平均标准摄取值（SUVmean）之比（LCR）被确定为3个月和6个月评估时临床成功的独立预测指标。3个月时LCR的曲线下面积（AUC）为0.894，6个月时为0.832。根据最佳截断值3.240将患者分为高LCR组和低LCR组。与低LCR组相比，高LCR组CXCR4和CYP11B2表达升高，醛固酮（PAC）水平更高，实现完全临床成功的概率更大。此外，LCR与定位指数和对侧抑制指数相关。
结论
LCR是PA患者术后血压恢复的可靠独立预测指标。LCR超过3.240的患者可能从肾上腺切除术中获益更多。我们建议对PA患者增加使用CXCR4 PET/CT。
注册信息
中国临床试验注册中心注册号：ChiCTR2200062844。于2022年8月20日注册。
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