Xp11.2易位/TFE3基因融合相关性肾癌的CT表现  

CT findings of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion

作　　者：成瑶[1,2] 王勇 张小勇[1] 常燕翔[1] 吴新生 CHENG Yao;WANG Yong;ZHANG Xiaoyong;CHANG Ycmxiang;WU Xinsheng(Department of Medical Imaging,Dongtai People＇s Hospital of Jiangsu Province,Dongtai 224200,P.R.China;Department of Medical Imaging,Nanfing General Hospital of Nanjing Military Cornmand/Jinling Hospital,Medical School of Nanfing Urtiversity,Nanfing 210002,P.R.China)

机构地区：[1]江苏省东台市人民医院医学影像科,江苏东台224200 [2]南京军区南京总医院/南京大学附属金陵医院医学影像科,江苏南京210002

出　　处：《医学影像学杂志》2018年第5期785-789,共5页Journal of Medical Imaging

摘　　要：目的探讨Xp11.2易位/TFE3基因融合相关性肾癌CT表现,以提高对该病的认识。方法搜集经手术病理证实的16例Xp11.2易位性肾癌以及同期的71例其他亚型肾癌的临床资料及CT资料,分析并比较其人口学资料以及肿瘤的CT表现。结果 16例Xp11.2易位性肾癌平均年龄31.2岁,右肾12例,左肾4例。各亚型肾癌的发生部位各组间无统计学差别(P均>0.05)。Xp11.2易位性肾癌最大径大于乳头状细胞肾癌(P=0.003),而其他组间比较未见统计学意义(P>0.05)。Xp11.2易位性肾癌较其他亚型细胞肾癌更容易出血(P均<0.05),坏死发生率明显低于透明细胞肾癌(P=0.015),而与其他亚型肾癌无统计学差异(P=0.183,P=0.723)。钙化发生率明显高于透明细胞肾癌(P<0.001)和乳头状细胞肾癌(P=0.001),与嫌色细胞肾癌无统计学差别(P=0.154)。转移发生率与透明细胞肾癌无统计学差别(P=0.108),高于乳头状细胞肾癌(P=0.050)和嫌色细胞肾癌(P=0.043)。Xp11.2易位性肾癌主要为持续强化型,与其他亚型肾细胞癌强化特征明显不同。结论 Xp11.2易位性肾癌临床及CT表现有一定的特征,综合分析有助于提高该病的诊断率。Objective To investigate the CT findings of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion and to improve the understanding of this entity. Methods Sixteen renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion and 71 other subtype renal cell carcinoma proven by histopathology were retrospectively collected and their demographics and CT findings were analyzed and compared. Results The average ages were 31. 2 years for 16 patients with Xp11.2 translocation/TFE3 gene fusion renal cell carcinoma. Twelve masses were located in right kidney and 4 in left kidney（all P〈0. 05）. The maximal diameter of Xp11.2 translocation/TFE3 gene fusion renal cell carcinoma was larger than papillary renal cell carcinoma（P = 0. 003） and had no difference with other subtype renal cell carcinoma（P〈0. 05）. The prevalence of intramural hemorrhage was the highest among 4 subtype renal cell carcinoma（all P〈0. 05）. Necrosis was significantly lower than clear cell renal cell carcinoma（P = 0. 015） but no difference with other subtype renal cell carcinoma（P = 0. 183,P =0. 723）. Intramural calcifications were significantly higher than clear cell renal cell carcinoma（P〈0. 001） and papillary renal cell carcinoma（P = 0. 001） and had no difference with chromophobe cell renal carcinoma（P = 0. 154）. Metastasis was observed more often than papillary renal cell carcinoma（P = 0. 050） and chromophobe cell renal carcinoma（P = 0. 043） but had no difference with clear cell renal cell carcinoma（P = 0. 108）. Enhancement pattern of Xp11.2 translocation/TFE3 gene fusion renal cell carcinoma was persistent enhancement type,which was different from other subtype renal cell carcinoma. Conclusion Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion has some typical CT findings,while comprehensive analysis can improve its diagnosis.

关 键 词：肾癌 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]