目的 研究18F-氟代脱氧葡萄糖(18F-fluorodexyglucose,18F-FDG)PET/CT显像和前列腺血清学指标诊断前列腺肿瘤的价值.方法 回顾性分析2013年8月至2021年12月在浙江大学医学院附属第二医院经病理证实的95例疑似前列腺肿瘤患者的18F-FDG PET/CT图像与前列腺血清学指标.根据病理检查结果分为恶性组(n=77)和良性组(n=18).采用受试者工作特征(receiver operating characteristic,ROC)曲线分析前列腺病灶的最大标准摄取值(maximum standardized uptake value,SUVmax)与血清总前列 腺特异性抗原(total prostate specific antigen,tPSA)、游离前列腺特异性抗原(free prostate specific antigen,fPSA)及游离/总前列腺特异性抗原比值(free/total prostate specific antigen,f/t-PSA)诊断前列腺良恶性病灶的最佳截断界值.结果 ROC曲线显示,SUVmax、tPSA、fPSA和f/t-PSA诊断前列腺良恶性病灶的最佳截断值分别为4.47、46.67 ng/mL、11.11 ng/mL和0.10.SUVmax、tPSA、fPSA和f/t-PSA 的 ROC 曲线下面积(area under the curve,AUC)分别为 0.658、0.897、0.842 和 0.836.18F-FDG PET/CT 显像、tPSA、fPSA和f/t-PSA对前列腺肿瘤的诊断敏感度分别是81.8％、97.4％、92.2％和83.1％,特异度分别是61.1％、27.8％、50.0％和50.0％,准确度分别是77.9％、84.2％、84.2％和76.8％.恶性组SUVmax、tPSA和fPSA均高于良性组,f/t-PSA低于良性组(均P＜0.05).18F-FDG PET/CT检查显示,72例有远处转移病灶.结论 SUVmax、tPSA、fPSA和f/t-PSA均能鉴别前列腺良恶性病灶.18F-FDG PET/CT显像在探测远处病灶方面更具有优势,能够为临床决策提供更好的帮助.
Value of 18F-FDG PET/CT and serological indicators in diagnosis of prostate tumor
Objective To investigate the diagnostic value of 18F-fluorodexyglucose(18F-FDG)PET/CT and prostate serological indicators in prostate tumor.Methods A total of 95 patients with 18F-FDG PET/CT and serological indicators performed for prostate lesions con-firmed by pathology at the Second Affiliated Hospital,Zhejiang University School of Medicine,from August 2013 to December 2021,were analyzed retrospectively.The patients were divided into malignant group(n=77)and benign group(n=18).Receiver operating characteristic(ROC)curves were used to find out the cut-off value of the maximum standardized uptake value(SUVmax),total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),and free/total prostate specific antigen(f/t-PSA)for diagnosing prostate tumor.Results ROC curves showed that the cut-off values of SUVmax,tPSA,fPSA,and f/t-PSA for diagnosing malignant prostate lesions were 4.47,46.67 ng/mL,11.11 ng/mL,and 0.10.The areas under the curves(AUCs)for SUVmax,tPSA,fPSA,and f/t-PSA were 0.658,0.897,0.842,and 0.836.The sensitivity,specificity,and accuracy value obtained by 18F-FDG PET/CT were 81.8％,61.1％,and 77.9％,respectively,97.4％,27.8％,and 84.2％by tPSA,92.2％,50.0％,and 84.2％by fPSA,and 83.1％,50.0％,and 76.8％by f/t-PSA.SUVmax,tPSA,and fPSA in the malignant group were all significantly higher than those in the benign group(all P＜0.05).f/t-PSA in the malignant group was significantly lower than that in the benign group(P＜0.05).18F-FDG PET/CT showed 72 patients with metastatic lesions.Conclusions SUVmax,tPSA,fPSA,and f/t-PSA were effective indicators to identify benign and malignant prostate lesions.18F-FDG PET/CT was more advantageous in exploring distant le-sions,providing better assistance for clinical decisions.
prostate tumorPET/CTmaximum standardized uptake valueprostate specific antigen
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