柠檬酸作为一种体内标志物用于鉴别前列腺癌与良性前列腺增生及正常前列腺外周带：通过局部质子光谱法进行检测。

Citrate as an in vivo marker to discriminate prostate cancer from benign prostatic hyperplasia and normal prostate peripheral zone: detection via localized proton spectroscopy.

作者信息

Kurhanewicz J, Vigneron D B, Nelson S J, Hricak H, MacDonald J M, Konety B, Narayan P

机构信息

Department of Radiology, University of California, San Francisco.

出版信息

Urology. 1995 Mar;45(3):459-66. doi: 10.1016/S0090-4295(99)80016-8.

DOI:10.1016/S0090-4295(99)80016-8

PMID:7533458

Abstract

OBJECTIVES

This study was designed to determine whether citrate levels detected by localized 1H spectroscopy could reliably discriminate regions of prostate adenocarcinoma from surrounding regions of normal peripheral zone and benign prostatic hyperplasia (BPH).

METHODS

In 28 patients and 5 volunteers stimulated echo proton spectroscopy was used in conjunction with endorectal surface coils to obtain water-suppressed 1H spectra from regions of normal prostate peripheral zone, BPH, and prostate cancer. 1H spectra from prostate cancer patients were correlated with pathologic areas identified on T2-weighted endorectal coil magnetic resonance (MR) images and histologic study of the step-sectioned gland after surgery.

RESULTS

The major finding of in vivo studies was consistently lower citrate levels in prostate cancer compared with BPH and normal prostate peripheral zone. This was reflected by significantly (P < 0.05) lower mean citrate/(creatine plus choline) peak area ratio observed for regions of cancer (0.67 +/- 0.17) compared with BPH (1.21 +/- 0.29) and normal peripheral zone (1.46 +/- 0.28). Moreover, there was no overlap of individual cancer and normal peripheral zone citrate ratios and no significant difference between citrate ratios in regions of normal peripheral zone in young volunteers (1.28 +/- 0.14) and age-matched patients (1.46 +/- 0.28). The observed alterations in vivo citrate levels were supported by citrate concentration data obtained from extracts of histologically proven samples of normal, benign, and malignant prostatic tissues removed at surgery. In vitro citrate levels in the normal peripheral zone (30.9 +/- 8.5 mumol/g wet weight) and BPH (46.3 +/- 5.4 mumol/g wet weight) were significantly higher than those for prostate cancer (3.74 +/- 0.54 mumol/g wet weight).

CONCLUSIONS

These studies further demonstrate the potential of citrate as an in vivo marker for discriminating prostate cancer from surrounding regions of normal peripheral zone and BPH.

摘要

目的

本研究旨在确定通过局部1H光谱检测到的柠檬酸盐水平能否可靠地区分前列腺腺癌区域与周围正常外周带和良性前列腺增生（BPH）区域。

方法

对28例患者和5名志愿者使用刺激回波质子光谱结合直肠内表面线圈，从正常前列腺外周带、BPH和前列腺癌区域获取水抑制1H光谱。前列腺癌患者的1H光谱与T2加权直肠内线圈磁共振（MR）图像上识别的病理区域以及手术后对分段腺体的组织学研究相关联。

结果

体内研究的主要发现是，与BPH和正常前列腺外周带相比，前列腺癌中的柠檬酸盐水平持续较低。这表现为，与BPH（1.21±0.29）和正常外周带（1.46±0.28）相比，癌症区域观察到的平均柠檬酸盐/（肌酸加胆碱）峰面积比显著更低（P<0.05）（0.67±0.17）。此外，个体癌症和正常外周带柠檬酸盐比率没有重叠，年轻志愿者（1.28±0.14）和年龄匹配患者（1.46±0.28）的正常外周带区域柠檬酸盐比率之间没有显著差异。手术切除的经组织学证实的正常、良性和恶性前列腺组织提取物获得的柠檬酸盐浓度数据支持了体内观察到的柠檬酸盐水平变化。正常外周带（30.9±8.5μmol/g湿重）和BPH（46.3±5.4μmol/g湿重）的体外柠檬酸盐水平显著高于前列腺癌（3.74±0.54μmol/g湿重）。