肾细胞癌T分期:术前增强计算机断层扫描的诊断准确性。

IF 1.4 Q4 ONCOLOGY
Salah M Fateh, Lusan A Arkawazi, Soran H Tahir, Rezheen J Rashid, Dalshad H Rahman, Ismaeel Aghaways, Fahmi H Kakamad, Abdulwahid M Salih, Rawa Bapir, Saman S Fakhralddin, Fattah H Fattah, Berun A Abdalla, Shvan H Mohammed
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引用次数: 1

摘要

肾细胞癌(RCC)占所有恶性肿瘤的1-2%,是成人最常见的肾脏肿瘤。影像学检查用于诊断和分期。肿瘤-淋巴结-转移分期强烈影响预后和治疗,而对比增强计算机断层扫描(CECT)被认为是局部和远处分期的标准成像技术。本研究旨在以手术分期和病理分期为参考,评价CECT对RCC术前分期的准确性。这项单中心前瞻性研究于2019年10月至2021年11月进行。我们回顾了怀疑患有肾细胞癌的患者术前腹部CT扫描。收集影像学资料,包括肿瘤部位、大小、肾周脂肪浸润情况。记录术中注意事项,包括手术类型、肾周脂肪浸润情况、肾静脉(RV)或下腔静脉(IVC)肿瘤扩展情况、周围脏器浸润情况。收集肿瘤大小、肾细胞癌类型、有无清晰边缘、有无肾包膜或肾周脂肪浸润、肾窦或肾盆腔系统(PCS)浸润、肾室节段性或主要延伸、Gerota筋膜及附近脏器受累等病理资料。术前CECT显示,59例肿瘤中有42例最大直径大于病理标本,总体差异为0.25 cm。CT对肿瘤侵犯肾周、肾窦脂肪及PCS的特异性为95%,敏感性为80% ~ 88%。CT检测T4期肿瘤的敏感性为83%,特异性为95,肾上腺浸润的特异性为100%。RV和IVC受累的影像学和组织学结果之间的一致性很高,特异性分别为94%和98%,敏感性分别为80%和100%。正确T分期的总体准确率为80%。综上所述,CECT对RCC的局部T分期是准确的,在估计肿瘤大小、检测肿瘤向附近结构的扩展和静脉侵犯方面具有很高的敏感性和特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Renal cell carcinoma T staging: Diagnostic accuracy of preoperative contrast-enhanced computed tomography.

Renal cell carcinoma T staging: Diagnostic accuracy of preoperative contrast-enhanced computed tomography.

Renal cell carcinoma T staging: Diagnostic accuracy of preoperative contrast-enhanced computed tomography.

Renal cell carcinoma T staging: Diagnostic accuracy of preoperative contrast-enhanced computed tomography.

Renal cell carcinoma (RCC) accounts for 1-2% of all malignancies and is the most common renal tumor in adults. Imaging studies are used for diagnosis and staging. Tumor-Node-Metastasis staging strongly affects prognosis and management, while contrast-enhanced computed tomography (CECT) is regarded as a standard imaging technique for local and distant staging. The present study aimed to evaluate the accuracy of CECT for the preoperative staging of RCC by using surgical and pathological staging as the reference methods. This single-center prospective study was conducted between October 2019 and November 2021. The preoperative abdominal CT scans of patients suspected of having RCC were reviewed. Imaging data were collected, including tumor side and size, and perinephric fat invasion. Intraoperative notes were recorded, including the operation type, perinephric fat invasion, renal vein (RV) or inferior vena cava (IVC) tumor extension, and surrounding organ invasion. pathological data were collected on tumor size, RCC type, presence of clear margins, presence of renal capsule or perinephric fat invasion, renal sinus or pelvicalyceal system (PCS) invasion, segmental or main RV extension, and the involvement of Gerota's fascia and nearby organs. Preoperative CECT revealed that 42 out of 59 tumors had a greater maximum diameter than the pathological specimen, with an overall disparity of 0.25 cm. The specificity of CT for the detection of tumor invasion of the perinephric and renal sinus fat and PCS was 95%, and the sensitivity ranged from 80 to 88%. CT had an 83% sensitivity and a 95 specificity in detecting T4 stage cancer, with a 100% specificity for adrenal invasion. The concordance between radiographic and histological results for RV and IVC involvement was high, with specificities of 94 and 98%, and sensitivities of 80 and 100%, respectively. Overall accuracy for correct T staging was 80%. In conclusion, CECT is accurate in the local T staging of RCC, with high sensitivity and specificity for estimating tumor size and detecting extension to nearby structures and venous invasion.

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