肾血管平滑肌脂肪瘤瘤体成分预测经动脉栓塞术后疗效

The application of tumor components of renal angiomyolipoma in predicting the early efficacy of arterial embolization treatment

目的探究肾血管平滑肌脂肪瘤(angiomyolipoma,AML)瘤体成分预测经肾动脉栓塞(selective arterial embolization,SAE)后的疗效。方法回顾性分析2019年8月至2023年4月宁夏医科大学总医院23例肾AML行SAE患者的临床资料。比较患者SAE前后肿瘤总体积、脂肪体积、非脂肪体积、脂肪体积占比、非脂肪体积占比。采用Pesrson相关分析各肿瘤成分初始体积与肿瘤体积减少率的关系,采用多元线性回归分析肿瘤体积减少率的影响因素。结果与SAE前相比,术后肿瘤体积、脂肪体积、非脂肪体积均显著缩小(均P<0.01),术后脂肪体积占比增加,非脂肪体积占比减小(P<0.05);术后肿瘤体积缩小值与肿瘤成分体积、破裂存在相关性(P<0.05);在多因素回归分析中,非脂肪成分体积占比为肿瘤体积减小的独立危险因素。结论肾AML经SAE后非脂肪体积占比减小,术前测量该指标有助于预测术后肿瘤体积缩小率,评估患者术后疗效。

Objective To discuss the clinical value of tumor components of renal angiomyolipoma(AML)in predicting the efficacy of selective arterial embolization(SAE).Methods The clinical data of 20 patients with AML,who received SAE treatment at the General Hospital of Ningxia Medical University of China between August 2019 and April 2023,were retrospectively analyzed.The pre-SAE and post-SAE total tumor volume,fat volume(FV),non-fat volume(NFV),proportion of FV,proportion of NFV were calculated.Pearson correlation analysis was used to analyze the relationship between the initial volume of each tumor component and the tumor volume reduction rate.Multiple linear regression analysis was used to analyze the factors affecting the tumor volume reduction rate.Results The postoperative tumor volume,FV,and NFV were all significantly reduced when compared with their preoperative values(all P<0.01).The postoperative proportion of FV was increased,and the postoperative proportion of NFV was decreased(P<0.05).The postoperative tumor volume reduction value was closely correlated with the volume of tumor components and the presence of rupture(P<0.05).Multivariate regression analysis revealed that the proportion of NFV was the independent risk factor for reduced tumor size.Conclusion After SAE,the proportion of NFV in AML is decreased.The preoperative measurement of this index can help clinicians to predict the postoperative tumor volume reduction ratio and to evaluate the postoperative efficacy of patients.