68Ga-PSMA-11 PET/CT前列腺癌假阳性病灶的病理学特点

打开文本图片集

Pathological characteristics of false-positive lesions of prostate cancer on 68Ga-PSMA-11 PET/CT

ABSTRACT：Objective

To investigate the pathological characteristics of false-positive lesions of prostate cancer on 68Ga-PSMA-11 PET/CT based on the pathology of whole mount specimens，in order to more accurately assess the degree of malignancy within the prostate tissue and avoid overdiagnosis and unnecessary treatment.Methods A total of 77 patients who underwent 68Ga-PSMA-11 PET/CT before radical prostatectomy in Nanjing Drum Tower Hospital during Jan.2018 and Dec.2022 were retrospectively analyzed.The pathology of whole mount specimens was detected.Two nuclear physicians examined all imaging plates without knowing the pathological results.Two pathological physicians completed all pathological diagnosis without knowing the imaging results.The pathological characteristics of false-positive lesions were determined by matching 68Ga-PSMA-11 PET/CT and pathological specimens.To analyze the pathological features of false-positive lesions，true-negative lesions were randomly delineated and defined.The pathological features of false-positive and true-negative lesions were analyzed and compared using Fisher exact test.Results After the imaging and pathological sections were matched，21（16.3%） false-positive lesions were identified.The pathological characteristics of the 21 false-positive lesions were as follows：16 （76.2%） simple atrophy with cyst formation，3（14.3%） prostatic nodular hyperplasia，and 2（9.5%） inflammation.The pathological characteristics of 21 true-negative lesions were：13（61.9%） normal glands，5（23.8%） prostatic nodular hyperplasia and 3（14.3%） simple atrophy with cyst formation.Fisher exact test showed that the proportion of simple atrophy with cyst formation in the pathological features of false-positive lesions and true-negative lesions was statistically significant （76.2% vs.14.3%，P<0.001）.Conclusion Simple atrophy with cyst formation may be a characteristic pathological type of the false-positive lesions of prostate cancer on 68Ga-PSMA-11 PET/CT.

KEY WORDS： 68Ga-PSMA-11 PET/CT; prostate cancer; radical prostatectomy; simple atrophy with cyst formation; pathological characteristic; false-positive; true-negative

摘要：目的 基于前列腺癌根治术后标本病理大切片探究68Ga-前列腺特异性膜抗原（PSMA）-11配体正电子发射/计算机断层扫描（PET/CT）前列腺癌假阳性病灶的病理特点，以期更准确地评估前列腺组织的恶性程度，避免过度诊断和不必要的治疗。（剩余9820字）