PSMA PET/CT和骨扫描在诊断前列腺癌骨转移方面的应用

Application of PSMA PET/CT and Bone Scan in the Diagnosis of Bone Metastases in Prostate Cancer

摘要: 前列腺癌是男性中第二大常见癌症，2020年有191,930例新诊断病例和33,330例因前列腺癌死亡。前列腺癌(PCa)进展时常发生骨转移。大约70%的晚期前列腺癌患者发生骨转移。近年研究表明早期诊断和治疗可显著降低癌症患者的病死率。前列腺癌转移最常见的部位是骨骼，目前临床诊断骨转移主要依赖骨扫描，而近年来以前列腺特异性膜抗原(Prostate specific membrane antigen, PSMA)为靶点的正电子发射型计算机断层显像(positron emission tomography, PET/CT)目前已在前列腺癌临床分期、复发转移的诊断等方面展现出显著优势，明显优于传统影像学检查，如骨扫描或CT (computed tomography)。对骨转移的诊断与疗效评估成为研究热点之一。目前PSMA靶向PET相对于骨扫描的优势是否在前列腺癌的分期、再分期和治疗反应评估中未得到证实。本文就PSMA PET/CT在前列腺癌在特定临床环境下的应用现状与价值进行综述。

Abstract: Prostate cancer is the second most common cancer in men, with 191,930 newly diagnosed cases and 33,330 deaths due to prostate cancer in 2020. Bone metastases often occur when prostate cancer (PCa) progresses. Approximately 70% of patients with advanced prostate cancer develop bone me-tastases. Recent studies have shown that early diagnosis and treatment can significantly reduce the mortality rate of cancer patients. The most common site of prostate cancer metastasis is bone, and at present, the clinical diagnosis of bone metastasis mainly relies on bone scanning, and in recent years, positron emission tomography (PET/CT) targeting prostate specific membrane antigen (PSMA) has been used in the clinical staging of prostate cancer. It has shown significant advantages in the diagnosis of recurrence and metastasis, and is significantly better than traditional imaging examinations, such as bone scan or computed tomography (CT). The diagnosis and efficacy evalua-tion of bone metastasis has become one of the research hotspots. Whether the current advantages of PSMA-targeted PET over bone scanning have not been demonstrated in the staging, restaging, and treatment response assessment of prostate cancer. This article reviews the application status and value of PSMA PET/CT in prostate cancer in specific clinical settings.