分子影像学杂志2026，Vol.49Issue(1)：50-55,6.DOI:10.12122/j.issn.1674-4500.2026.01.08
18F-PSMA-1007 PET/CT联合临床指标可有效预测前列腺癌不同转移状态
Combined use of 18F-PSMA-1007 PET/CT and clinical indicators effectively predicts different metastatic states in prostate cancer
摘要
Abstract
Objective To evaluate the relationship between distinct metastatic stages(non-metastatic,oligometastatic,and polymetastatic)of prostate cancer and 18F-prostate-specific membrane antigen(PSMA)-1007 PET/CT imaging characteristics together with clinical parameters.Methods A retrospective analysis was conducted on 269 pathologically confirmed prostate cancer patients who underwent 18F-PSMA-1007 PET/CT at the First Affiliated Hospital of Xinjiang Medical University from February 2022 to May 2025.Based on imaging findings,patients were categorized into non-metastatic(n=107),oligometastatic(n=60),and polymetastatic(n=102)groups.Comparative analysis of clinical and imaging parameters among groups was performed.Variables significant on univariate analysis were entered into multivariable logistic regression.ROC curves were constructed to evaluate the discriminative performance of risk factors for polymetastasis.Results Univariate analysis demonstrated significant differences(P<0.05)among groups in total prostate-specific antigen(TPSA),prostate-specific antigen density,free PSA(FPSA),the FPSA/TPSA ratio,Gleason score,International Society of Urological Pathology(ISUP)grading(low grade:1-3;high grade:4-5),tumor-to-background ratio(TBR),maximum standardized uptake value(SUVmax),mean SUV(SUVmean),total lesion glycolysis,metabolic tumor volume(MTV),and prostate volume(PV).Multivariable logistic regression revealed FPSA and ISUP as independent predictors of oligometastasis(P<0.05),while SUVmean,MTV,TPSA,PV,and ISUP were independent predictors of polymetastasis(P<0.05).ROC analysis indicated that TPSA achieved the highest diagnostic accuracy for polymetastasis(AUC=0.88,specificity=90.4%),whereas SUVmean demonstrated the highest sensitivity(94.1%).MTV and PV showed lower AUCs,sensitivity,and specificity compared with TPSA and SUVmean,with no significant differences between the MTV and PV metrics.Conclusion Integrating 18F-PSMA-1007 PET/CT metabolic parameters with clinical indicators enhances stratification of metastatic burden in prostate cancer.FPSA and ISUP are independent predictors of oligometastasis,while TPSA,SUVmean,MTV,PV,and ISUP serve as independent determinants of polymetastasis.关键词
前列腺癌/寡转移/危险因素Key words
prostate cancer/oligometastasis/risk factors引用本文复制引用
张文仙,李肖红,张奇洲,李毓斌,赵晓佳..18F-PSMA-1007 PET/CT联合临床指标可有效预测前列腺癌不同转移状态[J].分子影像学杂志,2026,49(1):50-55,6.基金项目
新疆维吾尔自治区自然科学基金(2019D01C307) （2019D01C307）
