nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2010-14-2-60-66nefr-1219Research ArticleЖУРНАЛ В ЖУРНАЛЕ. АКТУАЛЬНЫЕ ПРОБЛЕМЫ УРОЛОГИИJOURNAL IN THE JOURNAL. ACTUAL PROBLEMS OF UROLOGYЭФФЕКТИВНОСТЬ ¹¹C -ХОЛИН ПОЗИТРОННО-ЭМИССИОННОЙ ТОМОГРАФИИ В ДИАГНОСТИКЕ РЕЦИДИВА РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ ПОСЛЕ РАДИОТЕРАПИИTHE EFFECTIVENESS OF ¹¹C-CHOLINE POSITRON EMISSION TOMOGRAPHY IN THE DIAGNOSIS OF PROSTATE CANCER RECURRENCE AFTER RADIOTHERAPYДе ЙонгИ. Я.De YongI. Ya.

кафедра урологии

БреусмаА. Й.BreusmaA. Y.

кафедра урологии

Аль-ШукриС. Х.Al-ShukriS. H.

кафедра урологии

БоровецС. Ю.BorovetsS. Yu.

кафедра урологии

197022, Санкт-Петербург, ул. Л. Толстого, 17. Кафедра урологии СПбГМУ им. акад. И.П. Павлова.

РыбаловМ. А.RybalovM. A.

кафедра урологии

Медицинский центр университета г. ГронингенNetherlandsСанкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian Federation2010100220101426066Copyright © Де Йонг И.Я., Бреусма А.Й., Аль-Шукри С.Х., Боровец С.Ю., Рыбалов М.А., 20102010Де Йонг И.Я., Бреусма А.Й., Аль-Шукри С.Х., Боровец С.Ю., Рыбалов М.А.De Yong I.Y., Breusma A.Y., Al-Shukri S.H., Borovets S.Y., Rybalov M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1219

ЦЕЛЬЮ данного исследования является оценка эффективности и информативной значимости ¹¹C-холин позитронно-эмиссионной томографии (ПЭТ) в диагностике местного рецидива рака предстательной железы (РПЖ) у больных после радиотерапии. ПАЦИЕНТЫ И МЕТОДЫ. В основу исследования положены результаты обследования и лечения 52 больных, обследованных в клинике урологии медицинского центра университета г. Гронинген (Нидерланды) после проведенной им радиотерапии по поводу гистологически подтвержденного рака простаты. Производили сравнение клинико-морфологических параметров у пациентов с признаками местного рецидива РПЖ после радиотерапии, обнаруженного с помощью ПЭТ, с гистопатоморфологическими результатами биопсии предстательной железы. РЕЗУЛЬТАТЫ. По данным ПЭТ, местный рецидив был диагностирован у 42 больных: у 15 (36%) пациентов – одиночный рецидивный очаг новообразования, у 27 (64%) – «рассеянные» очаги. При этом совпадение данных ПЭТ с результатами биопсии простаты в диагностике рецидива имело место у 32 (76%) больных. Из остальных 10 пациентов: у трех больных были обнаружены отдаленные метастазы по данным ПЭТ, подтвержденные результатами компьютерной томографии и сцинтиграфии костей, двоим больным назначали гормональную терапию в связи с быстро прогрессирующей болезнью, пяти больным проведена локальная криотерапия, на фоне которой было отмечено снижение уровня простатоспецифического антигена (ПСА) в плазме крови. В целом, с помощью ПЭТ морфологически подтвержденный местный рецидив рака простаты удалось обнаружить у 37 из 42 (88%) пациентов. Совпадение результатов ПЭТ с результатами биопсии в отношении локализации рецидива было отмечено у 7 из 15 (47%) больных, у которых выявляли односторонний (в одной доле простаты) рецидив РПЖ, и у 11 из 27 (41%) – при двустороннем опухолевом процессе (в обеих долях). ЗАКЛЮЧЕНИЕ. Применение ¹¹C-холин ПЭТ позволяет в большинстве случаев выявлять местный рецидив РПЖ у больных, перенесших радиотерапию. Однако точность данного метода в определении распространенности очагов рецидивных новообразований РПЖ недостаточна, достоверные данные могут быть получены только с использованием биопсии предстательной железы.

THE AIM of this study is to evaluate the effectiveness and informative value ¹¹C-choline positron emission tomography (PET) in diagnosis of local recurrence of prostate cancer (PC) in patients after radiotherapy. PATIENTS AND METHODS. The research is based on the results of the survey and treatment of 52 patients examined in the clinic Urology Medical Center, University of Groningen (Netherlands) following radiotherapy at the hystologicaly confirmed prostate cancer. The comparison was made between the clinical and morphological parameters in patients with signs of local recurrence after radiotherapy of prostate cancer detected by PET, with hystopatomorfologicheskimi results of a biopsy of the prostate. RESULTS. According to PET, local recurrence was diagnosed in 42 patients: in 15 (36%) patients – a single focus of recurrent tumor, in 27 (64%) – «scattered» hot spots. This coincidence PET findings with the results of prostate biopsy in the diagnosis of recurrence occurred in 32 (76%) patients. Of the remaining 10 patients: three patients had distant metastases according to PET, confirmed by the results of computed tomography and bone scintigraphy, two of the patients had hormone therapy in connection with rapidly progressive disease, five patients underwent local cryotherapy, were was observed reduction in prostate antigen (PSA) in blood plasma. In general, using PET morphologically confirmed local recurrence of prostate cancer was detected in 37 out of 42 (88%) patients. The coincidence of the results of PET and biopsy results with regard to the localization of recurrence was noted in 7 of 15 (47%) patients who had revealed a unilateral (one share of the prostate), prostate cancer recurrence, and in 11 out of 27 (41%) – with bilateral neoplastic process ( in both lobes). CONCLUSION. Application of ¹¹C-choline PET in most cases to identify local recurrence of prostate cancer patients undergoing radiotherapy. However, the accuracy of this method in determining the prevalence of foci of recurrent tumors of prostate cancer is insufficient reliable data can be obtained only by using a biopsy of the prostate.

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The authors declare that there are no conflicts of interest present.