肾透明细胞癌CT征象与病理Fuhrman分级相关性研究  

Correlation between CT signs and pathological Fuhrman grading of renal clear cell carcinoma

作　　者：崔永胜[1] 张帅[2] 杨新国[1] 张凡涛[1] 王玉强[1] 苏伟[1] 罗涛[1] 刘佳兴 胡效坤[3] CUI Yongsheng;ZHANG Shuai;YANG Xinguo;ZHANG Fantao;WANG Yuqiang;SU Wei;LUO Tao;LIU Jiaxing;HU Xiaokun(CT Examination Department of Medical Imaging Consultation Center, Shengli Oilfield Central Hospital, Dongying 257000, P.R.China;Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao 266005, P.R.China;Intervention Medical Center of Affiliated Hospital of Qingdao University, Qingdao 266005, P.R.China)

机构地区：[1]山东省胜利油田中心医院医学影像会诊中心CT检查科,山东东营257000 [2]青岛大学附属医院放射科,山东青岛266005 [3]青岛大学附属医院介入医学中心,山东青岛266005

出　　处：《医学影像学杂志》2020年第7期1242-1245,共4页Journal of Medical Imaging

摘　　要：目的探讨肾脏透明细胞癌CT特征与Fuhrman病理分级的相关性。方法选择肾脏透明细胞癌患者60例,根据病理分级分为低级别组(Ⅰ级+Ⅱ级)46例和高级别组(Ⅲ级+Ⅳ级)14例,分析肿瘤CT影像学特征与病理核分级的相关性。结果低级别组与高级别组肿瘤比较,CT值在平扫、皮质期、髓质期及排泄期无统计学差异(P>0.05)。高级别肾癌组肿瘤长径大于低级别肾癌组,易于坏死,且假包膜不完整,静脉癌栓和肿瘤累及肾盂的发生率高于低等级肾癌组(P<0.05)。低级别组与高级别组包膜最厚处、包膜最薄处、包膜厚度差均没有统计学差异性(P>0.05)。结论肾脏透明细胞癌各期CT值与Fuhrman核分级无关联,但假包膜特征,静脉癌栓和累及肾盂与核分级有密切关联,可用于临床治疗方案及预后。Objective To investigate the correlation between CT features of clear cell carcinoma of the kidney and the pathological grade of Fuhrman.Methods From June 2015 to December 2018,60 patients with surgical surgical pathology confirmed renal clear cell carcinoma,according to the pathological grading,were divided into low level groups(Ⅰ+Ⅱ,46 cases)and high level group(Ⅲ+Ⅳ,14 cases),and the correlation of CT imaging features and pathological nuclear grade was analyzed.ResultsThere was no significant difference in CT value in plain scan,cortical stage,medulla stage and excretory stage between the low grade group and the high grade group(P>0.05).The tumor length and diameter of the high-grade renal carcinoma group were larger than those of the low-grade renal carcinoma group,which was prone to necrosis and had incomplete pseudocapsule.The incidence of venous thrombus or tumor involvement of the renal pelvis was higher than that of the low-grade renal carcinoma group(P<0.05).There was no statistical difference in the thickest,thinnest and thickness difference between the low-grade group and the high-grade group(P>0.05).Conclusion The CT values of each stage of clear cell carcinoma of the kidney have no correlation with Fuhrman nuclear grade,but the pseudocapsule characteristics,venous thrombus and involvement of the renal pelvis have close correlation with nuclear grade,which can be used as a reference for preoperative evaluation.

关 键 词：肾透明细胞癌 Fuhrman分级 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R737.11[医药卫生—放射医学]