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预测隐性淋巴结转移的临床参数阴性PSMA-PET患者的隐性淋巴结转移

Nicolai A Huebner¹, Gabriel Wasinger², Pawel Rajwa³

¹Department of Urology, Medical University of Vienna, Vienna, Austria; Working Group for Diagnostic imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), Vienna, Austria.

Urologic oncology

|January 21, 2024

概括

布里甘蒂2019名图表对于检测前列腺癌患者的淋巴结转移而不是最佳的,前列腺癌患者的PSMA-PET扫描结果为负. 需要更准确的方法来识别那些可以从进一步治疗中受益的患者.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
在瘤学瘤学.
核医学就是核医学.

背景情况:

在急性前列腺切除术 (RP) 期间,根据淋巴结 (LN) 转移风险推进行骨盆淋巴结解剖 (ePLND).
ePLND带有潜在的副作用,促使在改进成像的背景下对诊断工具进行评估.
术前[68Ga]Ga-PSMA-11PET扫描越来越多地用于评估RP之前的转移.

研究的目的:

为了评估布里甘蒂2019年名图的表现在前列腺癌患者的当代队列中,前手术前PSMA-PET扫描结果为负.
为了评估nomogram在预测淋巴结转移中的准确性.
在这个患者群体中确定与淋巴结转移相关的临床参数.

主要方法:

包括中等和高风险前列腺癌患者接受RP和ePLND的术前阴性[68Ga]Ga-PSMA-11 PET.
通过ROC分析和临床参数的后勤回归来评估nomogram的准确性.
在假阴性PSMA-PET扫描患者的样本上进行了AR和PSMA的免疫组织化学 (IHC).

主要成果:

该研究包括108名患者 (28%中等,72%高风险);12人患有隐藏的LN转移.
布里甘蒂2019年号码表显示准确度为0.62.
[68Ga]Ga-PSMA-11 PET具有89%的负预测值 (NPV).
数字直肠检查 (DRE) 和癌症核心的百分比与LN转移显著相关 (P<0.05).

结论:

布里甘蒂2019名图表对于检测阴性淋巴结转移在前列腺癌患者的阴性PSMA-PET扫描是不理想的.
虽然负的PSMA-PET可能允许对ePLND的值略高,但需要更精确的患者选择方法.
在PSMA-PET成像时代,ePLND的治疗效益与诊断效益需要重新评估.

关键词:

淋巴结剖析的解剖方法淋巴结转移的转移淋巴结转移这是一种PSMA连接体.这就是PSMA-PET.前列腺癌是什么意思前列腺癌是什么意思

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