前列腺特异性膜抗原（PSMA）定向应用在现代前列腺癌治疗中的应用，近几年发展迅速，有助于建立新的治疗途径，并为前列腺癌生物学提供更深入的洞察。但是，由于快速的临床实施，没有长期随访期来确定中期和长期肿瘤学结果，PSMA-PET的预后意义尚未得到系统研究。目前可用的数据表明，局部和生化复发疾病的男性中，传统的预后因素和生存结果与高 PSMA表达（根据免疫组化和 PET 摄取）有关。在存在 PSMA 阳性转移时，以治愈为目的的治疗（原发和/或营救治疗）通常会失败；然而，PSMA-PET 对检测所有转移的敏感性很低。反复发作疾病中的低 PSMA-PET 摄取是一个良好的预后因素；然而，在转移的去势耐药前列腺癌中，它可以与高 18F-氟脱氧葡萄糖摄取相关，导致预后不良。需要临床试验来嵌入 PSMA-PET，以引导具有可靠肿瘤学结果的管理，以支持持续的临床应用。 © 2022. Springer Nature Limited。

The use of prostate-specific membrane antigen (PSMA)-directed applications in modern prostate cancer management has evolved rapidly over the past few years, helping to establish new treatment pathways and provide further insights into prostate cancer biology. However, the prognostic implications of PSMA-PET have not been studied systematically, owing to rapid clinical implementation without long follow-up periods to determine intermediate-term and long-term oncological outcomes. Currently available data suggest that traditional prognostic factors and survival outcomes are associated with high PSMA expression (both according to immunohistochemistry and PET uptake) in men with localized and biochemically recurrent disease. Treatment with curative intent (primary and/or salvage) often fails when PSMA-positive metastases are present; however, the sensitivity of PSMA-PET in detecting all metastases is poor. Low PSMA-PET uptake in recurrent disease is a favourable prognostic factor; however, it can be associated with poor prognosis in conjunction with high 18F-fluorodeoxyglucose uptake in metastatic castration-resistant prostate cancer. Clinical trials embedding PSMA-PET for guiding management with reliable oncological outcomes are needed to support ongoing clinical use.© 2022. Springer Nature Limited.