CT对肾细胞癌亚型的诊断及鉴别诊断  

CT diagnosis and differential diagnosis of renal cell carcinoma subtypes

作　　者：于永梅[1] 王敏[1] 翟蕊[1] 李剑[1] 李正腾 潘冬梅 YU Yongmei;WANG Min;ZHAI Rui;LI Jian;LI Zhengteng;PAN Dongmei(CT Room,the First People's Hospital of Jining,Jining,Shandong Province 272000,China)

机构地区：[1]济宁市第一人民医院CT室,山东济宁272000

出　　处：《实用放射学杂志》2022年第10期1659-1663,共5页Journal of Practical Radiology

摘　　要：目的探讨肾细胞癌(RCC)亚型的CT特征,提高病变的鉴别诊断能力。方法回顾性分析48例经病理证实的RCC亚型的影像资料,其中12例Xp11.2易位/TFE3基因融合相关性肾细胞癌(Xp11.2/TFE3 RCC),21例肾嫌色细胞癌(CRCC),15例乳头状肾细胞癌(PRCC)。全部病例均行CT平扫及增强扫描,测量所有病例肿瘤各期相的CT值及健侧肾皮质的CT值,并计算多期相净增值、肿瘤-肾皮质强化指数,对RCC亚型CT征象及各数据进行分析。结果CT平扫结果显示,Xp11.2/TFE3 RCC患者的CT值与CRCC患者和PRCC患者比较差异均有统计学意义(P<0.05),而CRCC患者的CT值与PRCC患者比较差异无统计学意义(P>0.05)。增强扫描结果显示,Xp11.2/TFE3 RCC皮质期、实质期和排泄期的强化程度均明显高于CRCC患者和PRCC患者,差异均有统计学意义(P<0.05);CRCC患者和PRCC患者皮质期、实质期和排泄期的强化程度比较差异均无统计学意义(P>0.05)。与CRCC患者和PRCC患者相比,Xp11.2/TFE3 RCC患者的多期相净增值、肿瘤与肾皮质强化指数均升高,差异有统计学意义(P<0.05);CRCC患者和PRCC患者相比较,二者在皮质期及实质期多期净增值、肿瘤与肾皮质强化指数差异均有统计学意义(P<0.05),但在排泄期的差异无统计学意义(P>0.05)。结论RCC亚型的CT特点及强化参数有其特征性表现,多期相净增值、肿瘤-肾皮质强化指数和多期增强CT值,结合临床特点,可提高RCC亚型诊断及鉴别诊断。ObjectiveTo investigate the CT features of renal cell carcinoma(RCC)subtypes,and to improve the ability of differential diagnosis.Methods The imaging data of 48 patients with RCC subtypes confirmed by pathological were analyzed retrospectively,including 12 cases of Xpl1.2 translocation/TFE3 gene fusion associated renal cell carcinoma(Xpl1.2/TFE3 RCC),21 cases of chromophobe renal cell carcinoma(CRCC)and 15 cases of papillary renal cell carcinoma(PRCC).All cases underwent CT examinations(including CT plain-scan and CT enhanced-scan).The CT value of each phase of the tumor and the CT value of the contralateral renal cortex in all cases were measured,and the multi-phase net value increase and tumor-renal cortex enhancement index were calculated.The CT signs and data of different subtypes of RCC were analyzed.Results The results of plain CT scan showed that the CT values of Xpll.2/TFE3 RCC patients were significantly different from those of CRCC patients and PRCC patients(P<0.05).There was no significant difference in CT value between CRCC patients and PRCC patients(P>0.05).The enhanced scan results showed that the enhancement degree of Xpl1.2/TFE3 RCC in cortical,parenchymal and excretory phases was significantly higher than that of CRCC patients and PRCC patients,and the differences were statistically significant(P<0.05).And there was no significant difference in the degree of enhancement between CRCC patients and PRCC patients in cortical phase,parenchymal phase and excretory phase(P>0.05).Compared with CRCC patients and PRCC patients,Xpl1.2/TFE3 RCC patients had higher multi-phase net value increase,tumor-renal cortex enhancement index,and the difference was statistically significant(P<0.05);The differences of multi-phase net value increase,tumor-renal cortex enhancement index between CRCC patients and PRCC patients in cortical phase,parenchymal phase were statistically significant(P<0.05),but there was no significant difference in excretory phase(P>0.05).Conclusion RCC subtypes have their own characteristics in

关 键 词：肾细胞癌 亚型 计算机体层成像 

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