Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients
Gleason Score at Diagnosis Predicts the Rate of Detection of 18F-Choline PET/CT Performed When Biochemical Evidence Indicates Recurrence of Prostate Cancer: Experience with 1,000 Patients
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DOI：
10.2967/jnumed.114.141887
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发表时间：
2015-02-01
影响因子：
9.3
通讯作者：
Borsatti, Eugenio
中科院分区：
文献类型：
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作者：
Cimitan, Marino;Evangelista, Laura;Borsatti, Eugenio
本研究的目的是在一大群患者中探究初始格里森评分（GS）对使用F - 18 - 胆碱PET/CT检测复发性前列腺癌（PCa）几率的预测能力。
方法：从4个中心的数据库中获取2004年至2013年间因前列腺癌生化复发证据而接受F - 18 - 胆碱PET/CT检查的1000名患者的数据。连续数据采用学生t检验或方差分析进行比较，分类变量采用卡方检验进行比较。通过逻辑回归进行单变量和多变量分析。
结果：诊断时的GS在257名患者中≤6，在347名患者中为7，在396名患者中＞7。645次PET/CT扫描结果显示前列腺癌复发阳性。81%的阳性PET/CT结果出现在前列腺特异抗原（PSA）水平≥2 ng/mL的患者中，43%出现在PSA水平为1 - 2 ng/mL的患者中，31%出现在PSA水平≤1 ng/mL的患者中；78.8%的PET/CT阳性结果患者的GS＞7。300名患者的F - 18 - 胆碱PET/CT扫描结果为阴性；44%的患者GS≤6，35%的患者GS为7，17%的患者GS＞7。仅有5.5%的患者PET/CT结果被判定为不确定（中位PSA为1.8 ng/mL）。当GS＞7时，对于PSA水平＜1 ng/mL、1 - 2 ng/mL和＞2 ng/mL，F - 18 - 胆碱PET/CT的检测率分别为51%、65%和91%。在单变量和多变量分析中，GS为7以及GS＞7均是F - 18 - 胆碱PET/CT阳性结果的独立预测因子（优势比分别为0.226和0.330；两者的P值均为……（此处原文未完整给出P值相关内容））
The objective of this study was to explore the ability of the initial Gleason score (GS) to predict the rate of detection of recurrent prostate cancer (PCa) with F-18-choline PET/CT in a large cohort of patients. Methods: Data from 1,000 patients who had undergone F-18-choline PET/CT because of biochemical evidence of relapse of PCa between 2004 and 2013 were retrieved from databases at 4 centers. Continuous data were compared by the Student t test or ANOVA, and categoric variables were compared by the chi(2) test. Univariable and multivariable analyses were performed by logistic regression. Results: The GS at diagnosis was less than or equal to 6 in 257 patients, 7 in 347 patients, and greater than 7 in 396 patients. The results of 645 PET/CT scans were positive for PCa recurrence. Eighty-one percent of the positive PET/CT results were found in patients with a PSA level of greater than or equal to 2 ng/mL, 43% were found in patients with a PSA level of 1-2 ng/mL, and 31% were found in patients with a PSA level of less than or equal to 1 ng/mL; 78.8% of patients with positive PET/CT results had a GS of greater than 7. The results of F-18-choline PET/CT scans were negative in 300 patients; 44% had a GS of less than or equal to 6, 35% had a GS of 7, and 17% had a GS of greater than 7. PET/CT results were rated as doubtful in only 5.5% of patients (median PSA, 1.8 ng/mL). When the GS was greater than 7, the rates of detection of F-18-choline PET/CT were 51%, 65%, and 91% for a PSA level of less than 1 ng/mL, 1-2 ng/mL, and greater than 2 ng/mL, respectively. In univariable and multivariable analyses, both a GS of 7 and a GS of greater than 7 were independent predictors for positive F-18-choline PET/CT results (odds ratios, 0.226 and 0.330, respectively; P values for both,