主要阿尔多斯特罗尼斯症分类与18-氧皮质醇和-68-提克萨对于正子发射断层扫描/计算机断层扫描
Yinjie Gao1, Jie Ding2, Yu Wang3
1National Health Commission Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; Department of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
概括
使用液体染色学-并联质谱学 (LC-MS/MS) 和-68 (Ga) -pentixa的正子发射断层扫描 (PET) /计算机断层扫描 (CT) 可以准确地分类初级阿尔多斯特隆性 (PA) 亚型. 结合这些方法可以提高诊断的准确性,并可能避免侵袭性上腺静脉采样.
科学领域:
- 内分泌学 在内分泌学.
- 核医学就是核医学.
- 临床化学 临床化学
背景情况:
- 原发性阿尔多斯特隆症 (PA) 需要准确的亚型来进行适当的治疗.
- 目前用于PA亚型的方法可能具有侵入性或缺乏足够的准确性.
研究的目的:
- 评估用于分类原发性阿尔多斯顿主义亚型的非侵入性方法.
- 评估液体染色学-并联质谱学 (LC-MS/MS) 和-68 (Ga) -pentixa的诊断效率,用于正子发射断层扫描 (PET) /计算机断层扫描 (CT) 用于PA亚型.
主要方法:
- LC-MS/MS用于99名阿尔多生成腺瘤 (APA) 和61名具有异常性阿尔多的患者的类固醇分析.
- 68 用PET/CT进行Ga-pentixa对同一个队列进行.
- 统计分析确定了单个和组合方法的诊断效率.
主要成果:
- 在APA组中,LC-MS/MS检测到较高水平的6类类固醇 (不包括阿尔多),而非异常性阿尔多.
- 18-oxocortisol显示出高差异性诊断效率 (75.3%的灵敏度,91.2%的特异性).
- 在8.00的最佳SUVmax下,Ga-pentixafor PET/CT表现出高灵敏度 (93.7%) 和特异性 (93.7%).
- 结合18-oxocortisol水平和PET/CT视觉分析的Ga-pentixa,获得了95.2%的灵敏度,并正确分类了87.2%的患者.
结论:
- 对于PET/CT而言,LC-MS/MS和Ga-pentixa是PA亚型的宝贵的非侵入性工具.
- 这些方法的结合为PA分类提供了高准确度.
- 这种方法可以帮助避免在手术前不必要地抽取上腺静脉样本.
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