在前列腺癌中使用PSMA PET进行盆腔淋巴结分期:手术验证与放射治疗规划的影响
Alaattin Ozen1, Zeynep Sarikaya1, Cansu Gur1
1Basaksehir Cam ve Sakura City Hospital, Radiation Oncology Clinic, Istanbul, Turkey.
The Prostate
|January 22, 2026
概括
前列腺特异性膜抗原正子发射断层扫描/计算机断层扫描 (PSMA PET/CT) 扫描可以错过前列腺癌中的微观淋巴结转移. 即使有负PSMA PET/CT,11.8%的患者患有隐性结节疾病,这凸显了需要仔细规划治疗的必要性.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 核医学是一种核医学.
背景情况:
- 前列腺特异性膜抗原正子发射断层扫描/计算机断层扫描 (PSMA PET/CT) 是前列腺癌骨盆结节分期的组成部分.
- 它对微观结节疾病的负预测值不是绝对的.
- 这项研究验证了PSMA PET/CT发现与外科手术组织病理学相对应.
研究的目的:
- 确定阴性PSMA PET/CT扫描的前列腺癌患者隐性盆腔淋巴结转移的实际率.
- 评估PSMA PET/CT在排除显微节点疾病方面的可靠性.
- 为了识别与虚假阴性PSMA PET/CT结果相关的因素.
主要方法:
- 对51名中等至高/非常高风险前列腺癌患者的回顾性分析.
- 所有患者在骨盆淋巴结的手术前68Ga-PSMA PET/CT呈阴性.
- 进行了激进的前列腺切除术,并进行了扩展的盆腔淋巴结解剖; 基因病理学 (pN) 是参考标准.
主要成果:
- 组织病理学揭示了51名患者中的6名 (11.8%) 的盆腔淋巴结转移,尽管PSMA PET/CT.
- 有阳性节点 (pN+) 的患者年龄大得多,手术前PSA水平更高.
- 较高的手术前节点风险得分与PN+状态相关.
结论:
- 负的PSMA PET/CT扫描并不能可靠地排除前列腺癌中的微观盆腔淋巴结转移.
- 该研究表明,基于PSMA的节点分期具有显著的错误阴性率.
- 这些发现支持一种谨慎的,根据风险调整的方法来缓解PSMA PET/CT阴性患者的治疗升级.
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