不同亚型乳头状肾细胞癌CT影像鉴别与病理对照研究  

Differential and pathological study of different subtypes of papillary renal cell carcinoma by CT imaging

作　　者：王君广 周赵霞[2] 张夏 黄丽 WANG Junguang;ZHOU Zhaoxia;ZHANG Xia;HUANG Li(Department of Radiology,the Second Hospital of Yinzhou District,Ningbo 315100,China;Department of Radiology,NO.113 Hospital of People’s Liberation Army,Ningbo 315040,China)

机构地区：[1]宁波市鄞州区第二医院放射科,浙江宁波315100 [2]解放军第113医院放射科,浙江宁波315040

出　　处：《实用放射学杂志》2019年第3期418-421,共4页Journal of Practical Radiology

摘　　要：目的探讨乳头状肾细胞癌(PRCC)亚型的CT影像差异。方法回顾性分析30例经手术病理证实的PRCC的多期CT增强影像资料,将CT多期增强表现特点与病理对照研究。结果Ⅰ型16例,Ⅱ型14例,其中11例Ⅱ型PRCC呈不规则或分叶状,4例Ⅰ型呈分叶状,两者比较有统计学意义(P=0.003),5例Ⅱ型PRCC出现静脉癌栓,4例Ⅱ型PRCC淋巴结转移,6例Ⅱ型PRCC出现肾周侵犯,而Ⅰ型PRCC中1例出现静脉癌栓、2例出现肾周侵犯、未见淋巴结转移病例,两者比较均有明显差异(P=0.044,P=0.022,P=0.025)。PRCC平扫CT值、排泄期CT值、实质期CT值增值、排泄期CT值增值在2型之间无明显统计学意义(P=0.893,P=0.169,P=0.559,P=0.155),皮质期CT值、实质期CT值、皮质期CT值增值在2型之间有明显的统计学意义(P=0.013,P=0.046,P=0.008)。结论Ⅰ型和Ⅱ型PRCC在肿瘤形态、外侵征象及强化程度有一定差异,Ⅱ型PRCC容易出现肾周侵犯、癌栓及淋巴结转移,CT扫描对2型PRCC的鉴别诊断有重要价值。Objective To evaluate the image differences of CT in subtype papillary renal cell carcinoma(PRCC).Methods A retrospective analysis of 30 multiphase CT enhanced images of PRCC confirmed by operation and pathology in our hospital was performed, followed by a comparative study of CT multistage enhanced performance and pathology.Results type Ⅰ 16 cases, type Ⅱ 14 cases, of which 11 cases of Ⅱ type PRCC were irregular or lobulated, and 4 cases of type Ⅰ showed lobulated, there ware statistically significant differences between the two groups(P =0.003).Venous tumor thrombus in 5 cases of type Ⅱ PRCC,4 cases of type Ⅱ PRCC lymph node metastasis, perirenal invasion in 6 cases of Ⅱ type PRCC,but 1 case of Ⅰ PRCC had venous thrombus, perirenal invasion in 2 cases,no case of lymph node metastasis, there were obvious differences between the two groups( P = 0.044, P = 0.022, P = 0.025). PRCC plain scan CT value,CT value of excretory period,CT value added in the substantive period,CT increment during excretion period, there ware no significant statistical significance between type two groups(P = 0.893 , P = 0.169 , P= 0.559 , P = 0.155 ).CT value of cortical phase,CT value in perenchymal phase,CT value increment in cartical phase had significantly differences between two groups (P =0.013, P = 0.046 , P =0.008).Conclusion There are certain difference in tumor morphology,outside invasion signs and enhancement degree between typeⅠ and type Ⅱ PRCC and Ⅱ type PRCC is prone to appear perirenal invasion, tumor thrombus and lymph node metastasis.CT scanning is helpful in differential diagnosis of subtypes of PRCC.

关 键 词：乳头状肾细胞癌 计算机体层成像 病理学 

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