激素敏感性前列腺癌患者中PSMA PET/CT衍生参数与循环肿瘤DNA特征之间的相关性分析

潘剑; 叶定伟; 朱耀; 王备合

doi:10.19401/j.cnki.1007-3639.2024.07.007

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激素敏感性前列腺癌患者中PSMA PET/CT衍生参数与循环肿瘤DNA特征之间的相关性分析

论著 | 更新时间：2025-12-31

- 激素敏感性前列腺癌患者中PSMA PET/CT衍生参数与循环肿瘤DNA特征之间的相关性分析
- Correlation analysis of PSMA PET/CT-derived parameters and circulating tumor DNA features in patients with hormone-sensitive prostate cancer
- 中国癌症杂志 2024年34卷第7期页码：680-685
- 作者机构：
  
  复旦大学附属肿瘤医院泌尿外科，复旦大学上海医学院肿瘤学系，上海 200032
- 作者简介：
  
  [ "潘剑（ORCID: 0000-0002-8361-7529），博士。" ]
  王备合（ORCID: 0000-0002-0836-391X），博士，主治医师。
- 基金信息：
  
  国家自然科学基金(82203106);上海市抗癌协会“雏鹰”计划(SACA-CY22A04)
- DOI：10.19401/j.cnki.1007-3639.2024.07.007
  中图分类号： R737.25
- 收稿：2024-04-15，
  
  修回：2024-06-27，
  
  纸质出版：2024-07-30
- 稿件说明：
移动端阅览
潘剑, 叶定伟, 朱耀, 等. 激素敏感性前列腺癌患者中PSMA PET/CT衍生参数与循环肿瘤DNA特征之间的相关性分析[J]. 中国癌症杂志, 2024,34(7):680-685.

Jian PAN, Dingwei YE, Yao ZHU, et al. Correlation analysis of PSMA PET/CT-derived parameters and circulating tumor DNA features in patients with hormone-sensitive prostate cancer[J]. China Oncology, 2024, 34(7): 680-685.
潘剑, 叶定伟, 朱耀, 等. 激素敏感性前列腺癌患者中PSMA PET/CT衍生参数与循环肿瘤DNA特征之间的相关性分析[J]. 中国癌症杂志, 2024,34(7):680-685. DOI： 10.19401/j.cnki.1007-3639.2024.07.007.

Jian PAN, Dingwei YE, Yao ZHU, et al. Correlation analysis of PSMA PET/CT-derived parameters and circulating tumor DNA features in patients with hormone-sensitive prostate cancer[J]. China Oncology, 2024, 34(7): 680-685. DOI： 10.19401/j.cnki.1007-3639.2024.07.007.

摘要

背景与目的：

前列腺特异性膜抗原（prostate-specific membrane antigen，PSMA）正电子发射计算机体层显像（positron emission tomography/computed tomography，PET/CT）和循环肿瘤DNA（circulating tumor DNA，ctDNA）的检测结果都是激素敏感性前列腺癌（hormone-sensitive prostate cancer，HSPC）治疗决策的参考依据。本研究旨在分析HSPC患者中PSMA PET/CT衍生参数与ctDNA特征之间的相关性。

方法：

回顾性纳入于复旦大学附属肿瘤医院就诊且接受PSMA PET/CT和ctDNA测序的间隔≤2周、有完整病历记录的HSPC患者。排除存在除前列腺癌外的活动性恶性肿瘤，以及组织学特征支持纯神经内分泌癌或小细胞癌诊断的患者。本研究经复旦大学附属肿瘤医院伦理委员会批注（伦理编号：1909207-12）。采用Spearman相关系数评价PSM

A PET/CT衍生参数最大标准摄取值（maximum standardized uptake value，SUV

max

）、总肿瘤体积（total tumor volume，TTV）、病灶摄取总量（total lesion uptake，TLU）与ctDNA分数（ctDNA%）之间的相关性。

结果：

共纳入60例HSPC患者，

53（3.3%）、

BRCA

2（3.3%）和

ATM

（3.3%）是最常见的突变基因。在相关性分析中，ctDNA%与SUV

max

有显著相关性（Spearman’s rho=0.272，

=0.036）；ctDNA%与TLU（Spearman’s rho=0.160，

=0.222）和TTV（Spearman’s rho=0.162，

=0.215）无显著相关性。

结论：

SUV

max

与ctDNA%之间有显著相关性，提示与无PSMA阳性病灶和低PSMA摄取病灶的患者相比，存在高PSMA摄取病灶的患者接受联合靶向治疗的概率增加，本研究结果有望作为制订个体化治疗方案的参考。

Abstract

Background and purpose:

Both prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) and circulating tumor DNA (ctDNA) sequencing outcomes serve as references for therapeutic decision-making in hormone-sensitive prostate cancer (HSPC) treatment. This study aimed to analyze the association between PSMA PET/CT-derived parameters and ctDNA characteristics in patients with HSPC.

Methods:

HSPC patients who received PSMA PET/CT and ctDNA sequencing at an interval of less than 2 weeks and with complete medical records were retrospectively included in Fudan University Shanghai Cancer Center. Patients with active malignancies other than prostate cancer and those with histological features supporting a diagnosis of pure neuroendocrine carcinoma or small cell carcinoma were excluded. This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center (Ethics number: 1909207-12). The correlation between PSMA PET/CT-derived parameters

including the maximum standardized uptake value (SUVmax)

total tumor volume (TTV)

total lesion uptake (TLU) and ctDNA fraction (ctDNA%) was evaluated using the Spearman correlation coefficient.

Results:

A total of 60 HSPC patients were included

with

53 (3.3%)

BRCA

2 (3.

3%) and

ATM

(3.3%) being the most common mutated genes. In the correlation analysis

a significant correlation was observed between ctDNA% and SUVmax levels (Spearman’s rho=0.272

=0.036); however

no significant correlation was found between ctDNA% and TLU (Spearman’s rho=0.160

=0.222) or TTV (Spearman’s rho=0.162

=0.215).

Conclusion:

There was a significant correlation between SUVmax and ctDNA%

suggesting that patients with high PSMA uptake lesions were more likely to receive combined targeted therapy than patients with no PSMA positive lesions and patients with low PSMA uptake lesions

which provided a certain reference for the formulation of individualized treatment plans.

关键词

Keywords

references

DÖRR M , HÖLZEL D , SCHUBERT-FRITSCHLE G , et al. Changes in prognostic and therapeutic parameters in prostate cancer from an epidemiological view over 20 years [J ] . Oncol Res Treat , 2015 , 38 ( 1/2 ): 8 - 14 .

潘剑 , 朱耀 , 戴波 , 等 . 2022年度前列腺癌基础研究及临床诊疗新进展 [J ] . 中国癌症杂志 , 2023 , 33 ( 3 ): 210 - 217 . DOI: 10.19401/j.cnki.1007-3639.2023.03.003 http://doi.org/10.19401/j.cnki.1007-3639.2023.03.003

PAN J , ZHU Y , DAI B , et al. Advances in basic research, clinical diagnosis and treatment of prostate cancer in 2022 [J ] . China Oncol , 2023 , 33 ( 3 ): 210 - 217 .

WU J N , FISH K M , EVANS C P , et al. No improvement noted in overall or cause-specific survival for men presenting with metastatic prostate cancer over a 20-year period [J ] . Cancer , 2014 , 120 ( 6 ): 818 - 823 . DOI: 10.1002/cncr.28485 http://doi.org/10.1002/cncr.28485

CRAWFORD E D , PETRYLAK D , SARTOR O . Navigating the evolving therapeutic landscape in advanced prostate cancer [J ] . Urol Oncol , 2017 , 35S : S1 -S13. DOI: 10.1016/j.urolonc.2017.01.020 http://doi.org/10.1016/j.urolonc.2017.01.020

PAN J , YE D W , ZHU Y . Olaparib outcomes in metastatic castration-resistant prostate cancer: first real-world experience in safety and efficacy from the Chinese mainland [J ] . Prostate Int , 2022 , 10 ( 3 ): 142 - 147 . DOI: 10.1016/j.prnil.2022.04.005 http://doi.org/10.1016/j.prnil.2022.04.005

EMMETT L , METSER U , BAUMAN G , et al. Prospective, multisite, international comparison of 18 F-fluoromethylcholine PET/CT, multiparametric MRI, and 68 Ga-HBED-CC PSMA-11 PET/CT in men with high-risk features and biochemical failure after radical prostatectomy: clinical performance and patient outcomes [J ] . J Nucl Med , 2019 , 60 ( 6 ): 794 - 800 .

CALAIS J , CECI F , EIBER M , et al. 18 F-fluciclovine PET-CT and 68 Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial [J ] . Lancet Oncol , 2019 , 20 ( 9 ): 1286 - 1294 .

HOFMAN M S , LAWRENTSCHUK N , FRANCIS R J , et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study [J ] . Lancet , 2020 , 395 ( 10231 ): 1208 - 1216 . DOI: S0140-6736(20)30314-7 http://doi.org/S0140-6736(20)30314-7

CALAIS J , FENDLER W P , EIBER M , et al. Impact of 68 Ga-PSMA-11 PET/CT on the management of prostate cancer patients with biochemical recurrence [J ] . J Nucl Med , 2018 , 59 ( 3 ): 434 - 441 .

PIENTA K J , GORIN M A , ROWE S P , et al. A phase 2/3 prospective multicenter study of the diagnostic accuracy of prostate specific membrane antigen PET/CT with 18 F-DCFPyL in prostate cancer patients (OSPREY) [J ] . J Urol , 2021 , 206 ( 1 ): 52 - 61 .

HADASCHIK B , OST P . Re: assessment of 68 Ga-PSMA-11 PET accuracy in localizing recurrent prostate cancer: a prospective single-arm clinical trial [J ] . Eur Urol , 2019 , 76 ( 4 ): 538 - 539 .

PASCUAL J , ATTARD G , BIDARD F C , et al. ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group [J ] . Ann Oncol , 2022 , 33 ( 8 ): 750 - 768 . DOI: 10.1016/j.annonc.2022.05.520 http://doi.org/10.1016/j.annonc.2022.05.520

SHEN H R , LIU J L , CHEN K X , et al. Language model enables end-to-end accurate detection of cancer from cell-free DNA [J ] . Brief Bioinform , 2024 , 25 ( 2 ): bbae053 .

PAN J , WEI Y , ZHANG T W , et al. Stereotactic radiotherapy for lesions detected via 68 Ga-prostate-specific membrane ant igen and 18 F-fluorodexyglucose positron emission tomography/computed tomography in patients with nonmetastatic prostate cancer with early prostate-specific antigen progression on androgen deprivation therapy: a prospective single-center study [J ] . Eur Urol Oncol , 2022 , 5 ( 4 ): 420 - 427 .

PAN J , ZHAO J O , NI X D , et al. The prevalence and prognosis of next-generation therapeutic targets in metastatic castration-resistant prostate cancer [J ] . Mol Oncol , 2022 , 16 ( 22 ): 4011 - 4022 . DOI: 10.1002/1878-0261.13320 http://doi.org/10.1002/1878-0261.13320

PAN J , ZHAO J O , NI X D , et al. Heterogeneity of[ 68 Ga ] Ga-PSMA-11 PET/CT in metastatic castration-resistant prostate cancer: genomic characteristics and association with abiraterone response [J ] . Eur J Nucl Med Mol Imaging , 2023 , 50 ( 6 ): 1822 - 1832 .

SCHER H I , MORRIS M J , STADLER W M , et al. Trial design and objectives for castration-resistant prostate cancer: updated recommendations from the prostate cancer clinical trials working group 3 [J ] . J Clin Oncol , 2016 , 34 ( 12 ): 1402 - 1418 . DOI: 10.1200/JCO.2015.64.2702 http://doi.org/10.1200/JCO.2015.64.2702

PAN J , ZHANG T W , CHEN S Z , et al. Nomogram to predict the presence of PSMA-negative but FDG-positive lesion in castration-resistant prostate cancer: a multicenter cohort study [J ] . Ther Adv Med Oncol , 2024 , 16 : 17588359231220506 .

PAN J , WANG J , WEI Y , et al. Combination of body mass index and albumin predicts the survival in metastatic castration-resistant prostate cancer patients treated with abiraterone: a post hoc analysis of two randomized trials [J ] . Cancer Med , 2021 , 10 ( 19 ): 6697 - 6704 .

SARTOR O , BONO J D , CHI K N , et al. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer [J ] . N Engl J Med , 2021 , 385 ( 12 ): 1091 - 1103 .

HOFMAN M S , EMMETT L , SANDHU S , et al. [ 177 Lu ] Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial [J ] . Lancet , 2021 , 397 ( 10276 ): 797 - 804 .

EAPEN R S , BUTEAU J P , JACKSON P , et al. Administering[ 177 Lu ] Lu-PSMA-617 prior to radical prostatectomy in men with high-risk localised prostate cancer (LuTectomy): a single-centre, single-arm, phase 1/2 study [J ] . Eur Urol , 2024 , 85 ( 3 ): 217 - 226 .

COHEN S A , LIU M C , ALESHIN A . Practical recommendations for using ctDNA in clinical decision making [J ] . Nature , 2023 , 619 ( 7969 ): 259 - 268 .

JAHR S , HENTZE H , ENGLISCH S , et al. DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells [J ] . Cancer Res , 2001 , 61 ( 4 ): 1659 - 1665 .

VANDEKERKHOVE G , STRUSS W J , ANNALA M , et al. Circulating tumor DNA abundance and potential utility in de novo metastatic prostate cancer [J ] . Eur Urol , 2019 , 75 ( 4 ): 667 - 675 . DOI: S0302-2838(18)31050-9 http://doi.org/S0302-2838(18)31050-9

CORCORAN R B , CHABNER B A . Application of cell-free DNA analysis to cancer treatment [J ] . N Engl J Med , 2018 , 379 ( 18 ): 1754 - 1765 .

VOLIK S , ALCAIDE M , MORIN R D , et al. Cell-free DNA (cfDNA): clinical significance and utility in cancer shaped by emerging technologies [J ] . Mol Cancer Res , 2016 , 14 ( 10 ): 898 - 908 .

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