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在前列腺癌高风险生化复发患者中进行PSMA-PET成像:来自"EMBARK-Like"队列的含义

Matteo Droghetti¹, Valerio Pirelli², Francesco Ceci³

¹Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy. droghet@gmail.com.

Prostate cancer and prostatic diseases

|February 25, 2026

概括

前列腺癌患者的高风险生化复发 (BCR) 通常表明转移性疾病,可通过PSMA-PET成像检测. 这强调了需要将先进的成像与治疗策略相结合,以获得更好的结果.

科学领域:

在瘤学瘤学.
核医学是一种核医学.
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

在EMBARK试验中,使用恩扎胺加上抗雄激素剥夺疗法 (ADT) 改善了非转移性激素敏感前列腺癌 (nmHSPC) 与高风险生化复发 (BCR) 的存活率.
传统的成像可能会低估这些患者的转移性疾病,因为PSMA-PET提供了更高的灵敏度.

研究的目的:

评估使用PSMA-PET的高风险BCR前列腺癌患者转移性疾病的患病率.
将PSMA-PET的发现与EMBARK试验的高风险BCR标准进行比较.

主要方法:

在接受了PSMA-PET后进行了激进治疗后首次BCR的587名患者的回顾性分析.
基于高风险BCR的EMBARK标准的患者分层.
在EMBARK定义的高风险和非高风险组之间比较PSMA-PET阳性和转移性疾病检测率.

主要成果:

在169名符合EMBARK标准的患者中 (29%),82%显示PSMA-PET阳性,而其他患者中为39% (p < 0.001).
转移性疾病在46%的EMBARK高风险患者中被检测到,而15% (p < 0.001).
高风险BCR患者的PSA水平较高,PSA翻倍时间较短.

结论:

在高风险的BCR前列腺癌患者中,很大一部分患者在PSMA-PET上表现出转移性疾病,通常是传统分期错过的.
未来的研究应该专注于将全身疗法与PSMA-PET引导的转移导向治疗相结合,以治疗这一群体.

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