18F-MD-PSMA PET/CT显像在中高危前列腺癌初始分期中的应用价值

doi:10.3969/j.issn.1674-8115.2023.07.009

上海交通大学学报（医学版） ›› 2023, Vol. 43 ›› Issue (7): 873-881.doi: 10.3969/j.issn.1674-8115.2023.07.009

• 论著 · 临床研究 • 上一篇

¹⁸F-MD-PSMA PET/CT显像在中高危前列腺癌初始分期中的应用价值

严叶青¹(), 梁胜¹, 杨斌², 邹仁健¹, 马玉飞¹, 蔡利生³, 王辉¹, 傅宏亮¹()

^1.上海交通大学医学院附属新华医院核医学科，上海 ;200092
^2.同济大学附属第十人民医院泌尿外科，上海 200072
^3.美国国立卫生研究院，贝塞斯达 20816，美国

收稿日期:2023-03-02 接受日期:2023-05-18 出版日期:2023-07-28 发布日期:2023-07-28
通讯作者: 傅宏亮 E-mail:yanyeqing97@163.com;fuhongliang@hotmail.com
作者简介:严叶青（1997—），女，硕士生；电子信箱：yanyeqing97@163.com。
基金资助:
国家自然科学基金青年基金(82001856)

Role of ¹⁸F-MD-PSMA PET/CT in initial stage of intermediate and high risk prostate cancer

YAN Yeqing¹(), LIANG Sheng¹, YANG Bin², ZOU Renjian¹, MA Yufei¹, CAI Lisheng³, WANG Hui¹, FU Hongliang¹()

^1.Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
^2.Department of Urology, Tenth People′s Hospital of Tongji University, Shanghai 200072, China
^3.National Institutes of Health, Bethesda 20816, USA

Received:2023-03-02 Accepted:2023-05-18 Online:2023-07-28 Published:2023-07-28
Contact: FU Hongliang E-mail:yanyeqing97@163.com;fuhongliang@hotmail.com
Supported by:
National Natural Science Foundation of China(82001856)

摘要/Abstract

摘要：

目的·评估¹⁸F-MD-PSMA PET/CT在中高风险前列腺癌（prostate cancer，PCa）患者初始分期中的应用价值。方法·对2017年9月至2022年6月在上海交通大学医学院附属新华医院就诊的67例中高危PCa患者采用¹⁸F-MD-PSMA PET/CT进行初步分期；患者在¹⁸F-MD-PSMA PET/CT检查前2周内接受常规成像（conventional imaging，CI），包括多参数磁共振成像（multi-parameter magnetic resonance imaging，mp-MRI）和全身骨显像（bone scintigraphy，BS），其中25例患者同期进行了¹⁸F-FDG PET/CT检查。评估¹⁸F-MD-PSMA PET/CT对初始分期的灵敏度（sensitivity，SEN）、特异度（specificity，SPEC）、阳性预测值（positive predictive value，PPV）、阴性预测值（negative predictive value，NPV）及准确率（accuracy，ACU），并将结果与¹⁸F-FDG PET/CT、mp-MRI和BS的结果进行对比。以术后病理的T、N分期结果及临床随访的骨转移结果为参考标准进行Kappa一致性检验，分析¹⁸F-MD-PSMA PET/CT及CI在诊断原发灶累及范围、区域淋巴结转移、骨转移方面与参考标准的一致性，计算Kappa系数，并进行比较。结果·在67例PCa患者中，38例接受了根治性前列腺切除术并且有完整的病理学诊断资料，其中分别有27例和1例患者同时接受了区域淋巴结清扫术和扩大盆腔淋巴结清扫术，以病理结果作为诊断金标准。mp-MRI和¹⁸F-MD-PSMA PET/CT诊断包膜内病灶的检出率均为100%，诊断双侧腺叶内病灶的SEN分别为26.3%和63.2%，SPEC均为75.0%。与病理结果进行Kappa一致性检验，结果显示¹⁸F-MD-PSMA PET/CT诊断包膜外侵犯（extraprostatic extension，EPE）、精囊腺侵犯（seminal vesicle invasion，SVI）、膀胱颈侵犯（bladder neck invasion，BNI）的一致性均高于mp-MRI。Fisher确切概率法显示，2种检查方法诊断EPE、SVI的SEN（P=0.226，P=0.491）和SPEC（P=1.000，P=0.342），以及诊断BNI的SEN（均P=1.000）比较，差异均无统计学意义。在诊断淋巴结转移方面，基于淋巴结数量分析，¹⁸F-MD-PSMA PET/CT与病理结果的一致性高于mp-MRI（Kappa系数分别为0.555和0.137）；Fisher确切概率法提示2种检查方法的SEN和SPEC差异均无统计学意义（P=0.562，P=0.829）。基于患者分析，¹⁸F-MD-PSMA PET/CT与病理结果一致性高于mp-MRI（Kappa系数分别为0.850和0.313）；两者SEN比较，差异无统计学意义（P=1.000）。在诊断骨转移方面，基于骨病灶数量分析，¹⁸F-MD-PSMA PET/CT与随访结果的一致性高于BS（Kappa系数分别为0.500和0.299）；Fisher确切概率法提示2种检查方法的SEN比较，差异无统计学意义（P=0.219）。基于患者分析，¹⁸F-MD-PSMA PET/CT与随访结果的一致性高于BS（Kappa系数分别为0.953和0.766）；两者的SEN比较，差异无统计学意义（P=1.000）。¹⁸F-MD-PSMA PET/CT检测后，21例（31.3%）患者的风险分层上升，1例（1.5%）风险分层下降；32例（47.8%）患者的初始分期改变，其中27例（40.3%）上调，5例（7.5%）下调。结论·¹⁸F-MD-PSMA PET/CT在诊断中高风险PCa患者的双侧腺叶内病灶、EPE、SVI、区域淋巴结转移及骨转移方面，相比CI具有一定的优势，并在此基础上改变了部分患者临床分期及转移状态的诊断。

关键词: 前列腺癌, 初始分期, ¹⁸F-MD-PSMA PET/CT, 多参数磁共振成像, 全身骨显像

Abstract:

Objective ·To evaluate the role of ¹⁸F-MD-PSMA PET/CT in the initial stage of patients with moderate and high risk prostate cancer (PCa). Methods ·A total of 67 patients with moderate and high risk PCa who were treated in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from September 2017 to June 2022 were initially staged by ¹⁸F-MD-PSMA PET/CT. Conventional imaging (CI), including multi-parameter magnetic resonance imaging (mp-MRI) and bone scintigraphy (BS), were performed within two weeks before ¹⁸F-MD-PSMA PET/CT. Twenty-five patients underwent ¹⁸F-FDG PET/CT at the same time. The sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACU) of ¹⁸F-MD-PSMA PET/CT in the initial stage were evaluated, and the results were compared with those of ¹⁸F-FDG PET/CT, mp-MRI and BS. The consistency of ¹⁸F-MD-PSMA PET/CT and CI in terms of primary lesion, regional lymph node metastasis and bone metastasis was evaluated by Kappa consistency test refering to the postoperative pathological T and N staging results and bone metastasis results of clinical follow-up. Kappa coefficient was calculated and compared. Results ·Of the 67 patients with PCa, 38 patients underwent radical prostatectomy and had completed pathological data, with 27 patients undergoing regional lymphadenectomy and 1 patient undergoing expanded pelvic lymphadenectomy at the same time. The pathological results were obtained as gold standard. The detection rates of mp-MRI and ¹⁸F-MD-PSMA PET/CT in diagnosing intrathecal lesions were both 100%. The SENs in diagnosing bilateral intralobular lesions were 26.3% and 63.2%, respctively; the SPECs were both 75.0%.The Kappa consistency test showed that the consistency of ¹⁸F-MD-PSMA PET/CT in diagnosis of extracapsular extension (EPE), seminal vesicle invasion (SVI), and bladder neck invasion (BNI) was higher than that of mp-MRI. Fisher′s exact test showed that there were no statistically significant differences in SEN (P=0.226, P=0.491) and SPEC (P=1.000, P=0.342) between the two methods for diagnosing EPE and SVI, as well as SEN (P=1.000) for diagnosing BNI. In terms of diagnosis of lymph node metastasis, based on the analysis of lymph node numbers, the consistency between ¹⁸F-MD-PSMA PET/CT and pathological results was higher than that of mp-MRI (Kappa coefficients of 0.555 and 0.137, respectively). Fisher′s exact test showed that there were no statistically significant differences in SEN and SPEC between the two examination methods (P=0.562, P=0.829). Based on the patients, the consistency between ¹⁸F-MD-PSMA PET/CT and pathological results was higher than that of mp-MRI (Kappa coefficients of 0.850 and 0.313, respectively). There was no statistically significant difference in SEN between the two methods (P=1.000). In terms of diagnosis of bone metastasis, based on the analysis of bone lesion numbers, the consistency between ¹⁸F-MD-PSMA PET/CT and clinical follow-up results was higher than that of BS (Kappa coefficients of 0.500 and 0.299, respectively). Fisher′s exact test showed that there was no statistically significant difference in SEN between the two methods (P=0.219). Based on the patients, the consistency between ¹⁸F-MD-PSMA PET/CT and clinical follow-up results was higher than that of BS (Kappa coefficients of 0.953 and 0.766, respectively). There was no statistically significant difference in SEN between the two methods (P=1.000). The risks of 21 patients (31.3%) were increased after ¹⁸F-MD-PSMA PET/CT detection, with 1 patient (1.5%) decreasing. The initial stage of 32 cases (47.8%) were changed after ¹⁸F-MD-PSMA PET/CT detection, with 27 cases (40.3%) upstaged and 5 cases (7.5%) downstaged. Conclusion ·¹⁸F-MD-PSMA PET/CT is superior to CI in the diagnosis of bilateral intralobular lesions, EPE, SVI, regional lymph node metastasis and bone metastasis in intermediate and high risk PCa, and on this basis, the diagnosis of clinical stage and metastatic status of some patients has been changed.

Key words: prostate cancer, initial stage, ¹⁸F-MD-PSMA PET/CT, multi-parameter magnetic resonance imaging, bone scintigraphy

中图分类号:

R445.6

严叶青, 梁胜, 杨斌, 邹仁健, 马玉飞, 蔡利生, 王辉, 傅宏亮. ¹⁸F-MD-PSMA PET/CT显像在中高危前列腺癌初始分期中的应用价值[J]. 上海交通大学学报（医学版）, 2023, 43(7): 873-881.

YAN Yeqing, LIANG Sheng, YANG Bin, ZOU Renjian, MA Yufei, CAI Lisheng, WANG Hui, FU Hongliang. Role of ¹⁸F-MD-PSMA PET/CT in initial stage of intermediate and high risk prostate cancer[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(7): 873-881.

图/表 6

表1 CI与 18F-MD-PSMA PET/CT在PCa初始分期中的诊断效能比较

Tab 1 Comparison of diagnostic performance between CI and 18F-MD-PSMA PET/CT in initial staging of PCa

Organ/region examined	TP/n	FP/n	TN/n	FN/n	SEN/%	SPEC/%	PPV/%	NPV/%	ACU/%
EPE
mp-MRI	13	1	9	15	46.4	90.0	92.9	37.5	57.9
¹⁸F-MD-PSMA PET/CT	25	6	4	3	89.3	40.0	80.6	57.1	76.3
SVI
mp-MRI	3	2	25	8	27.3	92.6	60.0	75.8	73.7
¹⁸F-MD-PSMA PET/CT	8	5	22	3	72.7	81.4	61.5	88.0	78.9
BNI
mp-MRI	3	1	30	4	42.9	96.8	75.0	88.2	86.8
¹⁸F-MD-PSMA PET/CT	3	0	31	4	42.9	100.0	100.0	88.6	86.8
Regional lymph nodes (N1)
Per-lesion
mp-MRI	5	6	387	42	10.6	98.5	45.5	90.2	89.1
¹⁸F-MD-PSMA PET/CT	25	11	381	22	53.2	96.9	70.3	94.5	92.5
¹⁸F-FDG PET/CT	12	6	213	32	29.2	99.5	66.7	86.7	87.6
Per-patient
mp-MRI	3	0	17	8	27.3	100.0	100.0	68.0	71.4
¹⁸F-MD-PSMA PET/CT	10	1	16	1	90.9	94.1	90.9	94.1	92.9
¹⁸F-FDG PET/CT	5	3	6	0	62.5	96.3	66.7	100.0	78.6
Skeleton (M1b)
Per-patient
BS	13	2	32	3	81.3	94.1	86.7	91.4	90.0
¹⁸F-MD-PSMA PET/CT	15	0	34	1	93.8	100.0	100.0	97.1	98.0
Per-lesion
BS	11	8	366	34	25.0	97.9	57.9	91.5	90.0
¹⁸F-MD-PSMA PET/CT (per lesion)	24	18	356	21	54.5	95.2	57.1	94.4	90.7

表2 mp-MRI与 18F-MD-PSMA PET/CT诊断EPE、SVI、BNI与病理结果的一致性（n）

Tab 2 Consistency of mpMRI and 18F-MD-PSMA PET/CT in diagnosis of EPE， SVI and BNI with pathological results （n）

Imaging method	Pathologic diagnosis of EPE		Pathologic diagnosis of SVI		Pathologic diagnosis of BNI
Imaging method	+	-	+	-	+	-
mp-MRI
+	13	1	3	2	3	1
-	15	9	8	25	4	30
¹⁸F-MD-PSMA PET/CT
+	25	6	8	5	3	0
-	3	4	3	22	4	31

图1 一例患者mp-MRI与 18F-MD-PSMA PET/CT对盆腔淋巴结的评估结果比较Note： A. Pelvic mp-MRI showed enlargement of the right iliac lymph nodes with abnormal signal which supported the diagnosis of metastasis lymph nodes and a small left iliac lymph node (white thin arrows). B. 18F-MD-PSMA PET/CT demonstrated abnormal 18F-MD-PSMA uptake not only at the right iliac lymph nodes, but also at the left iliac lymph node which was less than 1 cm in diameter (white thick arrows). C. Maximum intensity projection (MIP) image demonstrated more abnormal 18F-MD-PSMA uptake of metastatic lymph nodes in pelvic region.

Fig 1 Comparison of evaluation results of pelvic lymph nodes between mp-MRI and 18F-MD-PSMA PET/CT in a patient

表3 mp-MRI与 18F-MD-PSMA PET/CT在诊断区域淋巴结转移方面与病理结果的一致性（n）

Tab 3 Consistency of mp-MRI and 18F-MD-PSMA PET/CT in diagnosis of regional lymph node metastasis with pathological results （n）

Imaging method	Pathologic diagnosis of lymph node metastasis
Imaging method	+	－
Per-patient
mp-MRI
+	3	0
-	8	17
¹⁸F-MD-PSMA PET/CT
+	10	1
-	1	16
Per-lesion
mp-MRI
+	5	6
-	42	387
¹⁸F-MD-PSMA PET/CT
+	25	12
-	22	381

表4 BS与 18F-MD-PSMA PET/CT在诊断骨转移方面与临床随访结果的一致性（n）

Tab 4 Consistency of BS and 18F-MD-PSMA PET/CT in diagnosis of bone metastasis with clinical follow-up results （n）

Imaging method	Clinical diagnosis of bone metastasis
Imaging method	+	-
BS
+	11	8
-	34	366
¹⁸F-MD-PSMA PET/CT
+	24	18
-	21	356

图2 一例患者BS与 18F-MD-PSMA PET/CT评估结果比较Note： A. BS image demonstrated oligometastasis status with 2 lesions in right hip joint and left pubic bone (black arrows). B. MIP image of 18F-MD-PSMA PET/CT demonstrated 6 lesions with high 18F-MD-PSMA uptake. C. Fusion images of PET and CT showed abnormal high uptake of 18F-MD-PSMA at bilateral ilium, right acetabulum and bilateral pubis (white arrows).

Fig 2 Comparison of evaluation results of BS and 18F-MD-PSMA PET/CT in a patient

参考文献 29

1	BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424.
2	顾秀瑛, 郑荣寿, 张思维, 等. 2000—2014年中国肿瘤登记地区前列腺癌发病趋势及年龄变化分析[J]. 中华预防医学杂志, 2018, 52(6): 586-592.
	GU X Y, ZHENG R S, ZHANG S W, et al. Analysis on the trend of prostate cancer incidence and age change in cancer registration areas of China, 2000 to 2014[J]. Chinese Journal of Preventive Medicine, 2018, 52(6): 586-592.
3	TROYER J K, BECKETT M L, WRIGHT G L. Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids[J]. Int J Cancer, 1995, 62(5): 552-558.
4	WRIGHT G L, HALEY C, BECKETT M L, et al. Expression of prostate-specific membrane antigen in normal, benign, and malignant prostate tissues[J]. Urol Oncol, 1995, 1(1): 18-28.
5	AFSHAR-OROMIEH A, MALCHER A, EDER M, et al. Reply to Reske et al.: pet imaging with a [⁶⁸Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions[J]. Eur J Nucl Med Mol Imaging, 2013, 40(6): 971-972.
6	WERNER R A, DERLIN T, LAPA C, et al. ¹⁸F-labeled, PSMA-targeted radiotracers: leveraging the advantages of radiofluorination for prostate cancer molecular imaging[J]. Theranostics, 2020, 10(1): 1-16.
7	FDA approves ¹⁸F-DCFPyL PET agent in prostate cancer[J]. J Nucl Med, 2021, 62(8): 11N.
8	KOH W J, ABU-RUSTUM N R, BEAN S, et al. Uterine neoplasms, version 1.2018, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2018, 16(2): 170-199.
9	METSER U, ORTEGA C, PERLIS N, et al. Detection of clinically significant prostate cancer with ¹⁸F-DCFPyL PET/multiparametric MR [J]. Eur J Nucl Med Mol Imaging, 2021, 48(11): 3702-3711.
10	SONNI I, FELKER E R, LENIS A T, et al. Head-to-head comparison of ⁶⁸Ga-PSMA-11 PET/CT and mpMRI with a histopathology gold standard in the detection, intraprostatic localization, and determination of local extension of primary prostate cancer: results from a prospective single-center imaging trial[J]. J Nucl Med, 2022, 63(6): 847-854.
11	DONATO P, ROBERTS M J, MORTON A, et al. Improved specificity with ⁶⁸Ga PSMA PET/CT to detect clinically significant lesions “invisible” on multiparametric MRI of the prostate: a single institution comparative analysis with radical prostatectomy histology[J]. Eur J Nucl Med Mol Imaging, 2019, 46(1): 20-30.
12	CAGLIC I, SUSHENTSEV N, SHAH N, et al. Comparison of biparametric versus multiparametric prostate MRI for the detection of extracapsular extension and seminal vesicle invasion in biopsy naïve patients[J]. Eur J Radiol, 2021, 141: 109804.
13	BOESEN L, CHABANOVA E, LØGAGER V, et al. Prostate cancer staging with extracapsular extension risk scoring using multiparametric MRI: a correlation with histopathology[J]. Eur Radiol, 2015, 25(6): 1776-1785.
14	POPIŢA C, POPIŢA A R, ANDREI A, et al. Local staging of prostate cancer with multiparametric-MRI: accuracy and inter-reader agreement [J]. Med Pharm Rep, 2020, 93(2): 150-161.
15	YILMAZ B, TURKAY R, COLAKOGLU Y, et al. Comparison of preoperative locoregional Ga-68 PSMA-11 PET-CT and mp-MRI results with postoperative histopathology of prostate cancer[J]. Prostate, 2019, 79(9): 1007-1017.
16	KOSEOGLU E, KORDAN Y, KILIC M, et al. Diagnostic ability of Ga-68 PSMA PET to detect dominant and non-dominant tumors, upgrading and adverse pathology in patients with PIRADS 4-5 index lesions undergoing radical prostatectomy[J]. Prostate Cancer Prostatic Dis, 2021, 24(1): 202-209.
17	UCAR T, GUNDUZ N, DEMIRCI E, et al. Comparison of 68Ga-PSMA PET/CT and mp-MRI in regard to local staging for prostate cancer with histopathological results: a retrospective study [J]. Prostate, 2022, 82(15): 1462-1468.
18	ÇELEN S, GÜLTEKIN A, ÖZLÜLERDEN Y, et al. Comparison of 68Ga-PSMA-I/T PET-CT and multiparametric MRI for locoregional staging of prostate cancer patients: a pilot study[J]. Urol Int, 2020, 104(9/10): 684-691.
19	ARSLAN A, KARAARSLAN E, LEVENT GÜNER A, et al. Comparing the diagnostic performance of multiparametric prostate MRI versus 68Ga-PSMA PET-CT in the evaluation lymph node involvement and extraprostatic extension[J]. Acad Radiol, 2022, 29(5): 698-704.
20	HOPE T A, EIBER M, ARMSTRONG W R, et al. Diagnostic accuracy of 68Ga-PSMA-11 PET for pelvic nodal metastasis detection prior to radical prostatectomy and pelvic lymph node dissection: a multicenter prospective phase 3 imaging trial[J]. JAMA Oncol, 2021, 7(11): 1635-1642.
21	MAURER T, GSCHWEND J E, RAUSCHER I, et al. Diagnostic efficacy of ⁶⁸gallium-PSMA positron emission tomography compared to conventional imaging for lymph node staging of 130 consecutive patients with intermediate to high risk prostate cancer[J]. J Urol, 2016, 195(5): 1436-1443.
22	WOO S, SUH C H, KIM S Y, et al. The diagnostic performance of MRI for detection of lymph node metastasis in bladder and prostate cancer: an updated systematic review and diagnostic meta-analysis [J]. AJR Am J Roentgenol, 2018, 210(3): W95-w109.
23	BUDÄUS L, LEYH-BANNURAH S R, SALOMON G, et al. Initial experience of ⁶⁸Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy [J]. Eur Urol, 2016, 69(3): 393-396.
24	YUMINAGA Y, ROTHE C, KAM J, et al. ⁶⁸Ga-PSMA PET/CT versus CT and bone scan for investigation of PSA failure post radical prostatectomy[J]. Asian J Urol, 2021, 8(2): 170-175.
25	PYKA T, OKAMOTO S, DAHLBENDER M, et al. Comparison of bone scintigraphy and ⁶⁸Ga-PSMA PET for skeletal staging in prostate cancer[J]. Eur J Nucl Med Mol Imaging, 2016, 43(12): 2114-2121.
26	ACAR E, BEKIŞ R, POLACK B. Comparison of bone uptake in bone scan and Ga-68 PSMA PET/CT images in patients with prostate cancer[J]. Curr Med Imaging Rev, 2019, 15(6): 589-594.
27	RUSTHOVEN C G, JONES B L, FLAIG T W, et al. Improved survival with prostate radiation in addition to androgen deprivation therapy for men with newly diagnosed metastatic prostate cancer [J]. J Clin Oncol, 2016, 34(24): 2835-2842.
28	SATKUNASIVAM R, KIM A E, DESAI M, et al. Radical prostatectomy or external beam radiation therapy vs no local therapy for survival benefit in metastatic prostate cancer: a SEER-medicare analysis[J]. J Urol, 2015, 194(2): 378-385.
29	OST P, REYNDERS D, DECAESTECKER K, et al. Surveillance or metastasis-directed therapy for oligometastatic prostate cancer recurrence: a prospective, randomized, multicenter phase Ⅱ trial [J]. J Clin Oncol, 2018, 36(5): 446-453.

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[5]	方晓 1, 2，郭建功 1，黄金明 1，樊连城 2. 预后营养指数预测转移性去势抵抗前列腺癌患者阿比特龙初始耐药和预后[J]. 上海交通大学学报（医学版）, 2019, 39(3): 316-.
[6]	陈鸣，傅晓红，吴墅，万永林. 前列腺特异抗原灰区患者前列腺癌的风险预估[J]. 上海交通大学学报（医学版）, 2019, 39(2): 217-.
[7]	刘利杰 1，洪西 1，黄先玉 3，罗静 3，俞建军 1, 2. 前列腺癌中巴豆酰化修饰的测定及与肿瘤分期和分级的相关性[J]. 上海交通大学学报（医学版）, 2018, 38(7): 788-.
[8]	潘玉龙1，齐隽2，周亮1，张彤彤1，李强1. 核糖体蛋白16高表达于前列腺癌并促进肿瘤进展[J]. 上海交通大学学报（医学版）, 2018, 38(4): 394-.
[9]	潘家骅，迟辰斐，董柏君，朱寅杰，邵晓光，王艳青，徐凡，沙建军，黄翼然，薛蔚. 多西他赛联合全雄阻断新辅助疗法治疗高危局部进展性前列腺癌的安全性[J]. 上海交通大学学报（医学版）, 2017, 37(6): 797-.
[10]	樊连城，董柏君，迟辰斐，潘家骅，王艳青，邵晓光，徐凡，上官勋，周立新 #，薛蔚 # . 阿比特龙联合泼尼松治疗转移性去势抵抗性前列腺癌的疗效及预后因素分析#br#[J]. 上海交通大学学报（医学版）, 2017, 37(11): 1483-.
[11]	付什，周娟，王忠 . 脂联素及其受体在前列腺癌中的作用和研究进展[J]. 上海交通大学学报（医学版）, 2017, 37(10): 1434-.
[12]	樊连城，董柏君，迟辰斐，潘家骅，沙建军，黄翼然，周立新，薛蔚. 阿比特龙联合泼尼松治疗未经化疗转移性去势抵抗性前列腺癌的有效性和安全性[J]. 上海交通大学学报（医学版）, 2016, 36(9): 1306-.
[13]	陈小溪，吴连明，张晓斐，等. 前列腺癌IVIM弥散加权成像与Gleason评分的相关性研究[J]. 上海交通大学学报（医学版）, 2014, 34(6): 868-.
[14]	杨艳, 陈莉. 前列腺癌患者去势治疗后心理障碍的原因分析及干预策略[J]. , 2011, 31(6): 730-.
[15]	丁奕星, 齐隽. TMPRSS2-ETS融合基因在前列腺癌中的研究进展及临床应用前景[J]. , 2011, 31(6): 852-.

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