肾透明细胞癌病理分级与其超声特征的相关性分析

Correlation between pathological grade and ultrasonographic features of clear cell renal carcinoma

目的超声检查的应用可提高肾透明细胞癌(CCRCC)的检出率。文中旨在分析肾透明细胞癌的超声特征与病理分级的相关性。方法回顾性分析2013年11月至2017年2月于南京军区南京总医院超声诊断科经病理证实的150例CCRCC患者常规超声与超声造影表现,并进行病理分级,其中低级别(I级与II级)CCRCC患者122例、高级别(III级与IV级)CCRCC患者28例。对CCRCC患者病理分级与其常规超声及超声造影特征的相关性进行统计学分析。结果肿块的最大径、最小径、有无假包膜、增强的均匀性与病理分级有关(P<0.01)。Logistic回归分析结果显示,病理分级主要相关因素为有无假包膜(OR=4.348,95%CI:1.252~15.096)及增强的均匀性(OR=11.425,95%CI:4.326~29.229)。结论 CCRCC病理分级的主要相关因素为假包膜及增强的均匀性,准确判断相关因素有利于外科医师手术方案的制定。

Objective To analyze the correlation between ultrasonographic features and pathological grade of clear cell renal carcinoma（CCRCC）. Methods We retrospectively analyzed the conventional ultrasound and contrast enhanced ultrasound in 150 cases of CCRCC from November 2013 to February 2017 which were confirmed by pathology in Institute of Nephrology of Nanjing Gener-al Hospital .Pathological grade was classified into Ⅰ , Ⅱ, Ⅲ,Ⅳ, with 122 cases of low grade CCRCC （grade Ⅰ and grade Ⅱ） and 28 cases of high grade CCRCC （ grade Ⅲ and grade Ⅳ ） .Their correlations with the features of conventional ultrasound and contrast en-hanced ultrasound were analyzed . Results The maximum diameter of the tumor （ low grade：40.00 ±16.11, high grade：56.43 ± 23.30）, the minimum diameter of the tumor（low grade：34.73±14.02,high grade：45.79±16.17）, rate of pseudocapsule displaying [low grade：presence52（74%）,absence70（26%）;high grade：presence4（14%）,absence24（86%）], and the enhanced uniformity [low grade：uniformity 19（16%）,Cystic change 95（78%）,necrosis 8（6%）;high grade：uniformity 5（18%）,Cystic change 1（4%）, necrosis 22（ 78%） ] were related to the pathological grade .Binary logistic regression analysis showed that the main factors related to the pathological grade were the rate of pseudocapsule displaying （OR：4.348,95%CI： 1.252-15.096）and the enhanced uniformity （OR：11.425,95%CI：4.326-29.229） Conclusion The characteristics of CCRCC conventional ultrasound and contrast-enhanced ultra-sound were related to the pathological grade , and the main factors were the rate of pseudocapsule displaying and enhanced uniformity .