不同病理亚型肾癌患者临床特点及MSCT诊断价值  

Clinical Features and MSCT Diagnostic Value of Patients with Different Pathological Subtypes of Renal Cell Carcinoma

作　　者：史凌波 李军[1] 孟庆涛[1] 蒋会东[1] SHI Ling-bo;LI Jun;MENG Qing-tao;JIANG Hui-dong(Department of Medical Imaging,the First People's Hospital of Chuzhou,Chuzhou 239000,Anhui Province,China)

机构地区：[1]滁州市第一人民医院影像科,安徽滁州239000

出　　处：《中国CT和MRI杂志》2021年第12期115-118,共4页Chinese Journal of CT and MRI

摘　　要：目的探究不同病理亚型肾癌患者临床特点及多层螺旋CT(MSCT)诊断价值。方法回顾性分析我院经术后病理证实为肾癌的91例患者术前MSCT资料及其他临床资料,病理亚型透明细胞癌64例、乳头状癌18例及嫌色细胞癌9例,比较不同病理亚型患者基本资料、MSCT检查结果,并分析手术病理与MSCT检查结果的差异。结果不同病理亚型患者一般资料、临床表现(除血尿)无明显差异(P>0.05),透明细胞癌患者血尿率明显高于其余病理亚型患者(P<0.05);三种病理亚型中嫌色细胞癌肿瘤最大径最大,大部分肾癌肿瘤形态不规则,钙化例数较少,但不同病理类型比较差异无统计学意义(P>0.05);乳头状癌出血率最高,透明细胞癌坏死/囊变率、密度不匀率最高而肿瘤边缘清晰率、强化均匀率最低,与其余病理亚型比较差异均有统计学意义(P<0.05);透明细胞癌患者平扫期CT值低于乳头状癌患者,皮质期、实质期及排泄期CT值高于其余病理亚型患者,差异有统计学意义(P<0.05);嫌色细胞癌患者平扫期CT值与其余病理亚型患者比较差异无统计学意义(P>0.05),皮质期、实质期及排泄期的CT值低于嫌色细胞癌患者,差异有统计学意义(P<0.05);MSCT检查分期总体准确率为86.81%(79/91),与病理分期结果的Kappa=0.785(P<0.05)。结论不同病理亚型肾癌患者MSCT征象存在一定差异,临床可通过MSCT检查的影像学信息初步判断患者肾癌亚型,指导临床治疗。Objective To explore the clinical features and diagnostic value of multi-slice spiral CT(MSCT)in patients with different pathological subtypes of renal cell carcinoma.Methods Retrospective analysis was performed on preoperative MSCT data and other clinical data of 91 patients with renal cell carcinoma confirmed by postoperative pathology in our hospital,including 64 cases of clear cell carcinoma,18 cases of papillary carcinoma and 9 cases of chromophobe cell carcinoma.The basic data and MSCT results were compared among patients with different pathological subtypes,and the differences between surgical pathology and MSCT results were analyzed.Results There were no significant differences in the general data and clinical manifestations(except hematuria)among patients with different pathological subtypes(P>0.05),and the hematuria rate of patients with clear cell carcinoma was significantly higher than that of patients with other pathological subtypes(P<0.05).Among the three pathological subtypes,the largest diameter of chromophobe cell carcinoma tumors was the largest,and most kidney cancer tumors had irregular morphology and fewer calcification cases,but there were no statistically significant differences among different pathological types(P>0.05).The bleeding rate was the highest in papillary carcinoma,and the necrosis/cystic change rate and density unevenness rate were the highest and the tumor edge sharpness rate and uniform enhancement rate were the lowest in clear cell carcinoma,and the differences Compared with the other pathological types were statistically significant(P<0.05).The CT value of the plain scan phase of patients with clear cell carcinoma was lower than that of patients with papillary carcinoma,and the CT values of cortical,parenchymal,and excretory phases were higher than those of other pathological subtypes(P<0.05).There was no statistically significant difference in the CT value of plain scan phase of patients with chromophobe cell carcinoma compared with that of other pathological subtypes(P>0

关 键 词：肾癌 病理亚型 临床特点 MSCT 诊断价值 

分 类 号：R692[医药卫生—泌尿科学] R445.3[医药卫生—外科学]