18F-PSMA-1007PET/CT对于根治性前列腺切除 术后切缘阳性的预测价值

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中图分类号：R816.7 文献标志码：ADOI：10.7652/jdyxb202503015

The predictive value of 18F⋅ -PSMA-1007 PET/CT for positive surgical margins after radical prostatectomy

， ， ， ， ， （PET/CT Center，The First Afiliated Hospital of Xi'an Jiaotong University， Xi'an 710061，China）

ABSTRACT： Objective The application of 18 F-PSMA-1oo7 PET/CT in the precise diagnosis and treatment of prostate cancer（PCa） is graduall increasing.This study aimed to explore the predictive value of 18F-PSMA-1007 PET/CT for positive surgical margins after radical prostatectomy （RP）.MethodsA total of 173PCa patients who were pathologicall confirmed and underwent RP in our hospital from July 2020 to August 2023 were retrospectively recruited.Allpatients underwent18F-PSMA-10o7 PET/CT whole-body imaging before surgery. According to the postoperative pathological results，they were divided into a negative surgical margin group with 83 cases and a positive surgical margin group with 9O cases.The differences in age， SUVmax，SUVmean，preoperative total prostate specific antigen （tPSA）， prostate specific antigen density（PSAD），prostate volume，Gleason score，and clinicalT staging between the groups were compared，and the risk factors were furtheranalyzed by Logistic regression. Results The preoperative tPSA（ Z=-3.252 ， P=0.001 ），SUVmax （ ，and clinical T staging （ P=0.018 ） were all lower in the negative surgical margin group than in the positive surgical margin group. PSAD （ OR=3.492 ， 95%CI 1.095-11.133 ， P=0.035 ），SUVmax（ OR=1.036 ！ 95%CI ： 1.003-1.070 ， P=0.034; ，and clinical Tstaging（ OR=3.364 ， 95%CI ： 1.117-10.133 ， P=0.045 ）were independent risk factors for positive surgical margins.Conclusion18 F-PSMA-1Oo7 PET/CT has certain predictive value for positive surgical margins after RP in PCa patients.High PSAD，high SUVmax and high clinical T stage were independent risk factors for predicting positive margin after PR surgery，thus providing some reference for the clinical treatment strategy of PCa patients.

KEY WORDS： prostate cancer （ ；prostate-specific membrane antigen （PSMA）；PET/CT； positive surgical margin；prediction

前列腺癌（prostatecancer，PCa）是中老年男性泌尿生殖系统的高发恶性肿瘤，其死亡率在全球男性恶性肿瘤中居于第五位，是世界一半以上国家中最常见的男性恶性肿瘤[1]。（剩余8073字）