氨基质子转移成像定量参数预测前列腺癌骨转移的价值

The value of quantitative parameters of amide proton transfer imaging in predicting bone metastasis of prostate cancer

目的:探讨氨基质子转移成像(amide proton transfer imaging,APT)定量参数对初诊前列腺癌患者骨转移风险的预测价值。方法:回顾并分析2019年7月—2022年3月于重庆大学附属肿瘤医院行APT检查的42例未经治疗的初诊前列腺癌患者的影像学及临床资料,患者均经前列腺穿刺活检或手术后病理学检查确诊,其中无骨转移组27例,骨转移组15例。采用独立样本t检验或秩和检验分析各参数在预测前列腺癌骨转移风险方面的差异。通过logistic回归模型测算参数联合应用的预测概率,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线进行分析。结果:年龄、睾酮、黄体生成素、卵泡刺激素、泌乳素、雌二醇、前列腺影像报告和数据系统(Prostate Imaging Reporting And Data System,PIRADS)评分在两组之间的差异无统计学意义(P>0.05),而总前列腺特异性抗原(prostate-specific antigen,PSA)、APT平均值(APTw)、表观弥散系数(apparent diffusion coefficient,ADC)、前列腺病理学Gleason评分及血清碱性磷酸酶在预测前列腺癌骨转移风险方面差异有统计学意义(P<0.05),前列腺癌骨转移阳性组的APTw(2.989±1.018)高于阴性组(2.273±1.015)。ROC曲线分析结果显示,APTw独立预测前列腺癌骨转移风险的特异度较高(88.46),所有参数联合应用的预测能力最佳(曲线下面积为0.866)。结论:APT定量参数与前列腺癌骨转移密切相关,对初诊前列腺癌患者转移风险有较好的预测价值。

Objective:To investigate the predictive value of quantitative parameters of amide proton transfer imaging(APT)on the risk of bone metastasis in newly diagnosed prostate cancer patients.Methods:Retrospective analysis was conducted on the imaging and clinical data of 42 untreated patients with prostate cancer diagnosed by prostate tissue puncture or surgery pathology from July 2019 to March 2022 who underwent APT examination in Chongqing University Cancer Hospital.There were 27 cases in non-bone metastasis group and 15 cases in bone metastasis group.Independent sample t test or rank sum test were used to analyze the difference of parameters in predicting the risk of prostate cancer bone metastasis.The prediction probability of joint application of parameters was calculated through the modeling of logistic regression model,and the receiver operating characteristic(ROC)curve is drawn for analysis.Results:The results showed that there was no significant difference between the two groups in age testosterone,luteinizing hormone,follicle stimulating hormone,prolactin,estradiol,and Prostate Imaging Reporting And Data System(PIRADS)score(P>0.05);there were statistically significant differences between total prostate-specific antigen(PSA),APTw,apparent diffusion coefficient(ADC),Gleason score of prostate puncture and serum alkaline phosphatase in predicting the risk of bone metastasis of prostate cancer(P<0.05).The ROC curve analysis showed that APTw had a high specificity(88.46)in independently predicting the risk of bone metastasis of prostate cancer,and the combination of all parameters had the best predictive ability(area under curve was 0.866).Conclusion:Quantitative parameters of APT are closely related to bone metastasis of prostate cancer,and can be an effective risk factor for predicting bone metastasis of prostate cancer.