PDF(Pubmed)
Abstract：
UNASSIGNED: The association between prostate-specific antigen (PSA) level and probability of metastatic disease on prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has not yet been established in patients with newly diagnosed prostate cancer (PCa). Our objective was to assess the probability of metastatic disease within different PSA ranges using PSMA PET/CT for initial staging of PCa, and to identify both the anatomical distribution and the predictors of metastases on PSMA PET/CT.
UNASSIGNED: In total, 2193 patients with newly diagnosed PCa were retrospectively studied. PSMA PET/CT was performed for staging purposes between January 2017 and May 2022. The proportion of patients with PSMA-avid metastases, stratified by PSA level, was studied. A vast majority of patients in whom at least one high-risk prognostic factor was present underwent PSMA PET/CT. A multivariable logistic regression analysis was performed to identify the predictors of metastases on PSMA PET/CT using clinical, biochemical, radiological, and pathological variables.
UNASSIGNED: The median PSA level at PSMA PET/CT was 14.1 ng/ml. Any metastatic disease (miN1-M1a-c) was observed in 34.7% (763/2193) of all patients and distant metastases (miM1a-c) in 25.4% (557/2193) of patients. The presence of any metastatic disease increased with PSA levels, being 15.4% in men with PSA levels <10 ng/ml and 87.5% in men with PSA levels >100 ng/ml. The multivariable logistic regression analysis found significant associations between the presence of any metastatic disease and PSA subgroups, clinical tumor stage ≥T2, grade group >3, and radiological tumor stage ≥T3b.
UNASSIGNED: This is the first large epidemiological study in patients with PCa demonstrating the association between PSA subgroups and metastatic disease on modern imaging PSMA PET/CT. Data from this study can be used to counsel patients on the probability of metastatic disease at the time of PSA screening and to provide guidance on existing guidelines.
UNASSIGNED: The prostate-specific antigen level could be used to assess the risk of metastases on prostate-specific membrane antigen positron (PSMA) emission tomography/computed tomography (PET/CT). This knowledge is valuable for selecting patients who will benefit most from metastatic screening with PSMA PET/CT.
UNASSIGNED: In total, 2193 patients with newly diagnosed PCa were retrospectively studied. PSMA PET/CT was performed for staging purposes between January 2017 and May 2022. The proportion of patients with PSMA-avid metastases, stratified by PSA level, was studied. A vast majority of patients in whom at least one high-risk prognostic factor was present underwent PSMA PET/CT. A multivariable logistic regression analysis was performed to identify the predictors of metastases on PSMA PET/CT using clinical, biochemical, radiological, and pathological variables.
UNASSIGNED: The median PSA level at PSMA PET/CT was 14.1 ng/ml. Any metastatic disease (miN1-M1a-c) was observed in 34.7% (763/2193) of all patients and distant metastases (miM1a-c) in 25.4% (557/2193) of patients. The presence of any metastatic disease increased with PSA levels, being 15.4% in men with PSA levels <10 ng/ml and 87.5% in men with PSA levels >100 ng/ml. The multivariable logistic regression analysis found significant associations between the presence of any metastatic disease and PSA subgroups, clinical tumor stage ≥T2, grade group >3, and radiological tumor stage ≥T3b.
UNASSIGNED: This is the first large epidemiological study in patients with PCa demonstrating the association between PSA subgroups and metastatic disease on modern imaging PSMA PET/CT. Data from this study can be used to counsel patients on the probability of metastatic disease at the time of PSA screening and to provide guidance on existing guidelines.
UNASSIGNED: The prostate-specific antigen level could be used to assess the risk of metastases on prostate-specific membrane antigen positron (PSMA) emission tomography/computed tomography (PET/CT). This knowledge is valuable for selecting patients who will benefit most from metastatic screening with PSMA PET/CT.
摘要：
■在新诊断的前列腺癌（PCa）患者中，尚未建立前列腺特异性抗原（PSA）水平与前列腺特异性膜抗原（PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）转移疾病的可能性之间的关联。我们的目标是使用PSMAPET/CT评估不同PSA范围内的转移性疾病的可能性，以进行PCa的初始分期。并确定PSMAPET/CT上转移的解剖分布和预测因素。
■总共，对2193例新诊断的PCa患者进行了回顾性研究。PSMAPET/CT在2017年1月至2022年5月期间进行分期。患有PSMA-vid转移的患者比例，按PSA水平分层，被研究过。绝大多数存在至少一个高危预后因素的患者接受PSMAPET/CT检查。进行了多变量逻辑回归分析，以确定PSMAPET/CT转移的预测因素，使用临床，生物化学，放射学,和病理变量。
■PSMAPET/CT的PSA中位数为14.1ng/ml。在所有患者的34.7％（763/2193）中观察到任何转移性疾病（miN1-M1a-c），在25.4％（557/2193）的患者中观察到远处转移（miM1a-c）。任何转移性疾病的存在随着PSA水平的增加而增加，PSA水平<10ng/ml的男性为15.4％，PSA水平>100ng/ml的男性为87.5％。多变量逻辑回归分析发现，任何转移性疾病的存在与PSA亚组之间存在显着关联。临床肿瘤分期≥T2，分级组>3，放射学肿瘤分期≥T3b。
■这是首次针对PCa患者的大型流行病学研究，证明了PSA亚组与现代PSMAPET/CT成像的转移性疾病之间的关联。这项研究的数据可用于指导患者在PSA筛查时发生转移性疾病的可能性，并为现有指南提供指导。
■前列腺特异性抗原水平可用于评估前列腺特异性膜抗原正电子（PSMA）发射断层扫描/计算机断层扫描（PET/CT）转移的风险。这些知识对于选择将从PSMAPET/CT转移筛查中受益最大的患者很有价值。
■总共，对2193例新诊断的PCa患者进行了回顾性研究。PSMAPET/CT在2017年1月至2022年5月期间进行分期。患有PSMA-vid转移的患者比例，按PSA水平分层，被研究过。绝大多数存在至少一个高危预后因素的患者接受PSMAPET/CT检查。进行了多变量逻辑回归分析，以确定PSMAPET/CT转移的预测因素，使用临床，生物化学，放射学,和病理变量。
■PSMAPET/CT的PSA中位数为14.1ng/ml。在所有患者的34.7％（763/2193）中观察到任何转移性疾病（miN1-M1a-c），在25.4％（557/2193）的患者中观察到远处转移（miM1a-c）。任何转移性疾病的存在随着PSA水平的增加而增加，PSA水平<10ng/ml的男性为15.4％，PSA水平>100ng/ml的男性为87.5％。多变量逻辑回归分析发现，任何转移性疾病的存在与PSA亚组之间存在显着关联。临床肿瘤分期≥T2，分级组>3，放射学肿瘤分期≥T3b。
■这是首次针对PCa患者的大型流行病学研究，证明了PSA亚组与现代PSMAPET/CT成像的转移性疾病之间的关联。这项研究的数据可用于指导患者在PSA筛查时发生转移性疾病的可能性，并为现有指南提供指导。
■前列腺特异性抗原水平可用于评估前列腺特异性膜抗原正电子（PSMA）发射断层扫描/计算机断层扫描（PET/CT）转移的风险。这些知识对于选择将从PSMAPET/CT转移筛查中受益最大的患者很有价值。
