Transitional cell carcinoma of the renal pelvis: A retrospective look at CT staging with pathologic correlation
Transitional cell carcinoma of the renal pelvis: A retrospective look at CT staging with pathologic correlation
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DOI：
10.1148/radiology.201.1.8816543
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发表时间：
1996-10-01
期刊：
影响因子：
19.7
通讯作者：
Fishman, EK
中科院分区：
文献类型：
--
作者：
Buckley, JA;Urban, BA;Fishman, EK
目得：为了确定的原因之间的差异，计算机断层扫描（CT）和病理分期肾盂移行细胞癌，并制定新的标准，以提高CT在staging.MATERIALS和METHODS的准确性：连续31例肾盂移行细胞癌的CT扫描进行了评价。结果：病理分期：0期4例，I期3例，II期5例，III期10例，IV期9例。初始总体CT分期准确率为52%（31例患者中的16例）。微小浸润的敏感性为17%（2/12例），三分之二（10/15例）的误诊病例被过度分期为III期。近端肾积水存在于80%的过度分期的情况下（8/10例）。以近端肾积水作为微创标准，重新评估CT研究提高了总体CT分期准确性（77%）。修订后的分期产生了83%的敏感性和95%的特异性为最小的侵袭和提高的特异性为深invasion（17%至92%hclass.CONCLUSION：在肾盂移行细胞癌的患者，肾积水近端的肿瘤可能会导致过度分期的0-II期疾病，并可能不表明更先进的疾病。
PURPOSE: To identify the reasons for the discrepancies between computed tomographic (CT) and pathologic staging of transitional cell carcinoma of the renal pelvis and to develop new criteria to increase the accuracy of CT in staging.MATERIALS AND METHODS: CT scans of 31 consecutive patients with renal pelvic transitional cell carcinoma were evaluated. CT and pathologic staging were compared.RESULTS: Pathologic staging revealed four stage 0 tumors, three stage I, five stage II, 10 stage III, and nine stage IV. The initial overall CT staging accuracy was 52% (16 of 31 patients). The sensitivity for minimal invasion was 17% (two of 12 patients), Two-thirds (10 of 15 patients) of the misinterpreted cases were overstaged as stage III. Proximal hydronephrosis was present in 80% of overstaged cases (eight of 10 patients). Reevaluation of the CT studies by using proximal hydronephrosis as a criterion for minimal invasion improved overall CT staging accuracy (77%). The revised staging yielded a sensitivity of 83% and specificity of 95% for minimal invasion and improved the specificity for deep invasion (17% to 92%).CONCLUSION: In a patient with transitional cell carcinoma of the renal pelvis, hydronephrosis proximal to the tumor may cause overstaging of stage 0-II disease and may not indicate more advanced disease.