摘要
目的分析18F-FDG PET/CT影像学检测、前列腺特异性膜抗原(PSMA)检测以及二者联合检测对前列腺癌的诊断价值。方法将2019年8月~2020年8月期间来本院检查或治疗的疑似前列腺癌患者133例纳入本次研究,经术后病理证实74例为前列腺癌患者,作为前列腺癌组,59例为前列腺增生者,作为前列腺增生组,两组年龄匹配。18F-FDG PET/CT法测定所有患者SUVmax值,以SUVmax值判定前列腺癌阴、阳性;免疫组化法测定所有患者PSMA表达,PSMA阳性则为前列腺癌阳性;18F-FDG PET/CT影像学或PSMA免疫组化测定阳性则判定为联合诊断阳性;分析18F-FDG PET/CT法、PSMA法、二者联合检测法与临床病理特征的一致性;采用四格表法分析并比较18F-FDG PET/CT、PSMA以及二者联合检测对前列腺癌的诊断价值。结果18F-FDG PET/CT共检测出68例前列腺癌阳性,65例前列腺癌阴性,其中7例误诊,13例漏诊,与病理学诊断具有较高的一致性(Kappa值=0.698,P<0.05);PSMA免疫组化共检测出62例前列腺癌阳性,71例前列腺癌阴性,其中4例误诊,16例漏诊,与病理学诊断具有较高的一致性(Kappa值=0.702,P<0.05);18F-FDG PET/CT联合PSMA共检测出70例前列腺癌阳性,57例前列腺癌阴性,其中6例误诊,4例漏诊,与病理学诊断具有较高的一致性(Kappa值=0.847,P<0.05);18F-FDG PET/CT联合PSMA诊断前列腺癌灵敏度、阴性预测值高于18F-FDG PET/CT影像学或PSMA免疫组化单独检测(P<0.05)。结论18F-FDG PET/CT与PSMA联合检测对前列腺癌的诊断效能显著高于18F-FDG PET/CT影像学单独检测,对前列腺癌的诊断具有指导作用。
Objective To analyze the diagnostic value of 18F-FDG PET/CT imaging detection,prostate-specific membrane antigen(PSMA)detection and their combined detection in prostate cancer.Methods A total of 133 patients with suspected prostate cancer who came to our hospital for examination or treatment from August 2019 to August 2020 were included in this study,postoperative pathology confirmed 74 patients with prostate cancer,as the prostate cancer group,and 59 patients with benign prostatic hyperplasia,as the benign prostatic hyperplasia group,the two groups were matched for age.18F-FDG PET/CT method was performed to determine the SUVmax value of all patients,and the SUVmax value was used to determine whether the prostate cancer was negative or positive;the expression of PSMA in all patients was determined by immunohistochemistry,and PSMA positive was positive for prostate cancer;any positive result of 18F-FDG PET/CT imaging or PSMA immunohistochemical assay was judged as a positive combined diagnosis;the consistency of 18F-FDG PET/CT method,PSMA method,and their combined detection method with clinicopathological characteristics was analyzed;the four-table method was used to analyze and compare the diagnostic value of 18F-FDG PET/CT,PSMA and their combined detection in prostate cancer.Results 18F-FDG PET/CT detected a total of 68 cases of prostate cancer positive and 65 cases of prostate cancer negative,of which 7 cases were misdiagnosed and 13 cases were missed,which had a high consistency with the pathological diagnosis(Kappa value=0.698,P<0.05);PSMA immunohistochemistry detected a total of 62 cases of prostate cancer positive and 71 cases of prostate cancer negative,among them,4 cases were misdiagnosed and 16 cases were missed,which had a high consistency with the pathological diagnosis(Kappa value=0.702,P<0.05);18F-FDG PET/CT combined with PSMA detected a total of 70 cases of prostate cancer positive and 57 cases of prostate cancer negative,of which 6 cases were misdiagnosed and 4 cases were missed,which had a high consistency with the pathological diagnosis(Kappa value=0.847,P<0.05);the sensitivity and negative predictive value of 18F-FDG PET/CT combined with PSMA in the diagnosis of prostate cancer were higher than those of 18F-FDG PET/CT imaging or PSMA immunohistochemical detection alone(P<0.05).Conclusion The combined detection of 18F-FDG PET/CT and PSMA has significantly higher diagnostic performance for prostate cancer than 18F-FDG PET/CT imaging alone,which has a guiding role in the diagnosis of prostate cancer.
作者
徐飞
彭向前
徐天才
熊义问
XU Fei;PENG Xiang-qian;XU Tian-cai;XIONG Yi-wen(Department of Radiology,Jianli People's Hospital,Jianli 433300,Hubei Province,China;Department of Urology,Jianli People's Hospital,Jianli 433300,Hubei Province,China)
出处
《中国CT和MRI杂志》
2024年第1期124-126,共3页
Chinese Journal of CT and MRI
