不同亚型肾癌CT定量分析、影像表现及其临床价值

Clinical value of CT imagings and quantitative analysis of different subtypes of renal cell carcinoma

目的:研究不同亚型肾癌的CT影像表现及CT定量分析的临床价值。方法:分析131例肾癌患者的影像资料,比较三种肾癌亚型患者的平扫及增强后CT值,并分析肾癌亚型与CT影像表现的关系。结果:透明细胞癌患者皮质期、实质期、排泄期CT值显著高于其他两种患者(P<0.05),呈现"快进快出"的特点;透明细胞癌患者中强化均匀者显著低于乳头状肾细胞癌和嫌色细胞癌患者(P<0.05);透明细胞癌患者发生坏死或囊变的概率显著高于其他两种患者(P均<0.05),嫌色细胞癌者发生坏死或囊变的概率低于乳头状肾细胞癌(P<0.05);透明细胞癌患者发生钙化的概率显著高于嫌色细胞癌(P<0.05);透明细胞癌患者肿瘤边缘清晰的概率显著低于显著低于其他两种亚型(P均<0.05)。结论:肾癌不同亚型的增强CT值和CT影像表现存在一定的差异,临床上能通过CT影像表现及CT定量分析对肾癌亚型进行初步判断,有一定的临床指导价值。

Objective: To study the clinical value of the CT images and CT quantitative analysis of different subtypes of renal cell carcinoma. Methods: Imaging data of 131 cases of renal cell carcinoma confirmed by surgery and biopsy from December 2015 to December 2017 were Analysised. Among these cases, 91 cases of clear cell carcinoma, 24 cases of papillary renal cell carcinoma, and 16 cases of chromophobe cell carcinoma. The plain and enhanced CT values of three kidney cancer subtypes were compared, and the relationship between subtypes of renal cancer and CT image performance was analyzed. Results: Cortical, parenchymal, and excretion CT values of patients with clear cell carcinoma were significantly higher than those of papillary renal cell carcinoma and chromophobe carcinoma ( P<0.05), showing "fast-forward and rapid-out" characteristics. Patients with enhanced uniformity in clear cell carcinoma patients was 23.08%, which was significantly lower than papillary renal cell carcinoma patients and chromophobe cell tumor patients (62.50%)( P<0.05).The probability of necrosis or cystic degeneration in patients with clear cell carcinoma is 76.92%, which is significantly higher than that of papillary renal cell carcinoma 54.17% and chromophobe cancer 31.25%( P<0.05). The probability of necrosis or cystic degeneration of chromophobe is significantly lower than that of papillary renal cell carcinoma. The probability of calcification in patients with clear cell carcinoma was 27.47%, which was significantly higher than that of chromophobe 6.25%( P<0.05). The probability of clear edge of tumor in patients with bright cell carcinoma is 28.57%, which is significantly lower than that of papillary renal cell carcinoma 83.33% and chromophobe 87.50%( P<0.05). Conclusion: There are certain differences in the enhanced CT values and CT images of different subtypes of renal cell carcinoma. Clinical CT scans and CT quantitative analysis can be used to make initial judgments on subtypes of renal cancer, and have certain clinical guiding value for the treatment of renal cell carcinoma.