摘要
目的探讨4种少见病理亚型肾癌的多层螺旋CT(MSCT)表现及病理特点,以提高对4种少见病理亚型肾癌诊断准确率。方法回顾性分析经病理证实的29例4种少见病理类型肾癌的CT表现及病理学特征,其中乳头状肾细胞癌(PRCC)7例,嫌色细胞癌(CRCC)11例,黏液样小管状和梭形细胞癌(MTSRCC)3例,Xp11.2易位/TFE3基因融合相关性肾癌(Xp11.2RCC)8例,并对CT表现进行统计学分析。结果 7例PRCC中有坏死囊变者2例,出血者1例,钙化1例;11例CRCC中伴有出血者2例,伴有坏死囊变者4例,伴钙化者2例;3例MTSRCC中1例发生钙化,3例均无坏死囊变、出血;8例Xp11.2RCC中6例肿瘤内可见点状钙化,1例伴有出血,4例伴有坏死囊变。平扫PRCC组与Xp11.2RCC组,MTSRCC组与Xp11.2RCC组CT值比较差异均有统计学意义(P<0.05);皮质期PRCC组与CRCC组、Xp11.2RCC组,MTSRCC组与Xp11.2RCC组CT值比较差异均有统计学意义(P<0.05);实质期PRCC组与CRCC组、Xp11.2RCC组CT值比较差异均有统计学意义(P<0.05),CRCC组与MTSRCC组、Xp11.2RCC组CT值比较差异均有统计学意义(P<0.05),MTSRCC组与Xp11.2RCC组CT值比较差异有统计学意义(P<0.05);肾盂期PRCC组与Xp11.2RCC组,CRCC组与Xp11.2RCC组,MTSRCC组与Xp11.2RCC组CT值比较差异均有统计学意义(P<0.05)。结论根据肿瘤形态、大小、密度、内部情况等CT征象,结合动态增强扫描肿瘤CT值变化特点,可以提高4种少见病理亚型肾癌诊断准确率。
Objective To investigate The MSCT expression and pathological characteristics of 4 different rare different pathological types of renal carcinoma,in order to improve preoperative accuracy of rare type renal carcinoma.Methods Retrospective analysis the CT signs and pathologic characteristics of the four kinds of rare pathological type of renal cancer,7 cases of papillary renal cell carcinoma,chromophobe renal cell carcinoma in 11 cases,renal myxoid small tubular and spindle cell carcinoma 3 cases,Xp11.2 translocation/TFE3 gene fusions correlation of kidney cancer 8 cases,and statistical analysis was carried out on the CT performance.Results In 7 cases of papillary renal cell carcinoma,there were 2 cases of necrotic cystic degeneration,1 case of hemorrhage and 1 case of calcification.There were 11 cases of renal cell carcinoma with hemorrhage in 2 cases,4 cases with necrotic cystic lesions and 2 cases with calcification.Calcification occurred in 1 of 3 cases of renal mucinous tubule and spindle cell carcinoma,and no necrotic cystic degeneration or hemorrhage occurred in 3 cases.In 8 cases of Xp11.2 translocation/TFE3 gene fusion associated renal cancer,there were 6 cases of intratumoral calcification,1 case with bleeding and 4 cases with necrotic cystic lesions.The CT values of PRCC group,Xp11.2 RCC group and MTSRCC group and Xp11.2 RCC group were significantly different(P<0.05).CT values of cortical PRCC group,CRCC group,Xp11.2 RCC group and MTSRCC group and Xp11.2 RCC group were significantly different(P<0.05).Substantial period PRCC and CRCC group,Xp11.2 RCC of CT value comparison difference had statistical significance(P<0.05),CRCC group compared with MTSRCC group,Xp11.2 RCC CT value differences were statistically significant(P<0.05),MTSRCC group compared with CT value Xp11.2 RCC group difference was statistically significant(P<0.05);Comparison of CT values between the pyeloneal PRCC group,Xp11.2 RCC group,CRCC group,Xp11.2 RCC group and MTSRCC group and Xp11.2 RCC group was statistically significant(P<0.05).Co
作者
陈伟
王亚婷
史玉振
周海飞
柏根基
郭莉莉
CHEN Wei;WANG Yating;SHI Yuzhen(The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第9期1684-1688,共5页
Journal of Clinical Radiology
