基于术前增强CT探讨肾透明细胞癌瘤周静脉特征与WHO/ISUP分级的关系  

Study on the Relationship between the Characteristics of Peritumoralvein and WHO/ISUP Grade of Renal Clear Cell Carcinoma Based on Preoperative Enhanced CT

作　　者：石宇婷 倪良平 张岱 王龙胜[1] SHI Yuting;NI Liangping;ZHANG Dai(Department of Radiology,The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui Province 230601,P.R.China)

机构地区：[1]安徽医科大学第二附属医院放射科,合肥230601

出　　处：《临床放射学杂志》2023年第12期1951-1955,共5页Journal of Clinical Radiology

摘　　要：目的基于术前增强CT探讨肾透明细胞癌(ccRCC)瘤周静脉的特征与世界卫生组织(WHO)/国际泌尿病理协会(ISUP)分级的关系。方法回顾性分析安徽医科大学第二附属医院2018年5月至2021年12月经术后病理证实为ccRCC且有明确病理分级的250例患者资料。将ccRCC瘤周静脉定义为实质期在Gerota筋膜内与受累肾脏相邻的不对称增加且形态不规则的血管。按有无瘤周静脉将250例病例分为两组,观察两组的影像特征并分析有无瘤周静脉与WHO/ISUP分级的关系。对于有瘤周静脉的病例,进一步分析瘤周静脉的支数,最大内径,空间构型(有无交叉)与WHO/ISUP分级的关系。并利用Spearman相关分析瘤周静脉支数与WHO/ISUP分级的相关性。结果250例ccRCC患者中有瘤周静脉的有146例(58.4%),无瘤周静脉的有104例(41.6%)。有瘤周静脉的患者较无瘤周静脉的患者肿瘤直径更大、更容易出现囊变坏死(P<0.05)。两组间患者年龄、性别、体重指数(BMI)、肿瘤位置、有无癌栓的差异无统计学意义(P>0.05)。ccRCC患者瘤周静脉的有无,支数,空间构型与WHO/ISUP分级的差异有统计学意义(P<0.05)。且瘤周静脉支数与WHO/ISUP分级呈正相关(r=0.310,P<0.001)。瘤周静脉的最大内径与WHO/ISUP分级的差异无统计学意义(P>0.05)。结论ccRCC瘤周静脉的特征与WHO/ISUP分级相关,术前评估瘤周静脉对患者的临床治疗决策具有指导意义。Objective To explore the relationship between the characteristics of peritumoral veins and WHO/ISUP grade in clear cell renal cell carcinoma(ccRCC)based on preoperative enhanced CT.Methods The data of 250 patients with postoperative pathologically confirmed ccRCC with clear pathological grades from May 2018 to December 2021 at the Second Affiliated Hospital of Anhui Medical University were retrospectively analyzed.The peritumoral veins of ccRCC were defined as asymmetrically increased and irregularly shaped vessels adjacent to the affected kidney within Gerota's fascia in the parenchymal stage.The 250 cases were divided into two groups according to the presence or absence of peritumoral veins.The imaging features of the two groups were observed and the relationship between the presence or absence of peritumoral veins and WHO/ISUP classification was analyzed.For cases with peritumoral veins,the relationship between the number of branches,maximum diameter,spatial configuration(with and without crossings)of peritumoral veins and WHO/ISUP grade was further analyzed.Spearman correlation was used to analyze the correlation between the number of peritumoral veins and WHO/ISUP grade.Results There were 146(58.4%)patients with peritumoral veins and 104(41.6%)patients without peritumoral veins in 250 patients with ccRCC.Compared with patients without peritumoral veins,patients with peritumoral veins have larger tumor diameter and are more prone to cystic necrosis(P<0.05).There was no statistically significant difference in age,gender,BMI,tumor location,and presence of cancerous emboli between the two groups(P>0.05).There were significant differences in the presence,absence,number and spatial configuration of peritumoral veins between ccRCC patients and WHO/ISUP classification(P<0.05).There was a positive correlation between the number of peritumoral veins and WHO/ISUP grade(r was 0.310,P<0.001).There was no significant difference between the maximum diameter of peritumoral vein and WHO/ISUP grade(P>0.05).Conclusion The char

关 键 词：肾透明细胞癌 瘤周静脉 WHO/ISUP分级 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学]