文章：

前列腺特异性膜抗原（PSMA）PET/CT在肝细胞癌（HCC）检测与诊断中的应用：一项系统综述与荟萃分析

Prostate-Specific Membrane Antigen (PSMA) PET/CT in the Detection and Diagnosis of Hepatocellular Carcinoma (HCC): A Systematic Review and Meta-Analysis

原文发布日期：19 November 2024

DOI: 10.3390/cancers16223865

类型: Article

开放获取: 是

英文摘要：

Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is widely used in prostate cancer. Recent studies indicate hepatocellular carcinoma (HCC) demonstrates PSMA PET uptake. The diagnostic accuracy of PSMA PET for HCC is not known. We conducted a systematic review and meta-analysis of studies assessing68Ga-PSMA-11 in HCC. Nine studies were included, with 196 patients and a total of 491 HCC lesions. Per-patient analysis yielded a pooled sensitivity of 89.8% (95% CI 78.5–95.5). Specificity was poorly reported, with insufficient data. When per-lesion level analysis was performed on seven studies, the pooled sensitivity was 94.5% (95% CI 82.9–98.4), and specificity was again poorly reported with insufficient data. Among the three studies with adequate data for full per-lesion meta-analysis, 115 lesions in 41 patients demonstrated sensitivity of 97.1% (95% CI 87.8–99.4), while specificity was 42.2% (95% CI 0.3–99.4). Two studies provided sufficient data for meta-analysis on a per-patient level (n= 50 patients), demonstrating a sensitivity of 92.5% (95% CI 64.0–98.9) and specificity of 72.4% (95% CI 1.3–99.8). PSMA PET demonstrates a high sensitivity for HCC and shows promise as an imaging modality for diagnosis and staging of HCC. However, the existing literature does not provide enough data to confidently evaluate its specificity and, therefore, accuracy. Further prospective studies are necessary, with a focus on the accurate reporting of benign lesions and inclusion of patients with an intermediate probability of HCC.

摘要翻译： 

前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）在前列腺癌中应用广泛。近期研究表明，肝细胞癌（HCC）亦表现出PSMA PET摄取，但其对HCC的诊断准确性尚未明确。本研究对评估⁶⁸Ga-PSMA-11在HCC中应用的研究进行了系统综述与荟萃分析。共纳入9项研究，涉及196例患者及491个HCC病灶。基于患者的分析显示汇总敏感度为89.8%（95% CI 78.5–95.5），但特异性数据报告不足且信息有限。对其中7项研究进行病灶水平分析时，汇总敏感度为94.5%（95% CI 82.9–98.4），特异性数据同样报告不充分。在3项具备完整病灶水平荟萃分析数据的研究中，41例患者的115个病灶显示敏感度为97.1%（95% CI 87.8–99.4），特异性为42.2%（95% CI 0.3–99.4）。两项研究提供了患者水平的充足数据（n=50例），显示敏感度为92.5%（95% CI 64.0–98.9），特异性为72.4%（95% CI 1.3–99.8）。PSMA PET对HCC具有高敏感度，有望成为HCC诊断与分期的影像学手段。然而现有文献数据不足以准确评估其特异性及诊断准确性。未来需开展更多前瞻性研究，重点关注良性病灶的准确报告及纳入中概率HCC患者群体。

原文链接：

Prostate-Specific Membrane Antigen (PSMA) PET/CT in the Detection and Diagnosis of Hepatocellular Carcinoma (HCC): A Systematic Review and Meta-Analysis