Urinary collecting system invasion on multiphasic CT in renal cell carcinomas: prevalence, characteristics, and clinical significance.
Urinary collecting system invasion on multiphasic CT in renal cell carcinomas: prevalence, characteristics, and clinical significance.
复制标题
肾细胞癌多相 CT 上的泌尿收集系统侵犯：患病率、特征和临床意义。
DOI：
10.1007/s00261-020-02859-y
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Gabata T.
中科院分区：
文献类型：
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作者：
Takamatsu A;Yoshida K;Obokata M;Inoue D;Yoneda N;Kadono Y;Kobayashi S;Gabata T.
目的探讨肾细胞癌(RCC)多期CT上集合系统侵犯(CSI)的发生率，验证其病理表现，并探讨CSI与临床预后的关系。根据多期CT图像上有无CSI表现分为两组。分析比较两组患者的临床特征、放射学表现、总生存率(OS)和无复发生存率(RFS)。结果在340例患者的347个肾脏中，11个肾脏出现CSI(3%，95%可信区间，1.3-5.0%)。11个肾脏肿瘤均经病理诊断为透明细胞肾细胞癌，其中1个肾脏肿瘤还具有肉瘤样特征。以病理CSI为标准，CT诊断CSI的敏感性、特异性和准确性分别为50%、99.7%和97.1%。CT上有CSI的患者与无CSI的患者的OS和RFS发生率无显著差异。结论本研究发现肾癌相关性CSI的患病率为3%。由于发病率低，我们不能排除CT上的CSI与OS和RFS相关的可能性。需要进一步的研究来确定CT上的CSI是否可以作为肾癌患者生存的独立预后因素。
PurposeThe aim of this study was to determine the prevalence of collecting system invasion (CSI) on multiphasic CT, validate the pathological findings, and investigate the relationship between CSI and clinical outcomes in patients with renal cell carcinomas (RCC).MethodsPatients pathologically diagnosed with RCC between January 2008 and December 2017 were retrospectively enrolled in this study. They were divided into two groups according to the presence of CSI on multiphasic CT images. Patients’ clinical characteristics, radiological findings, and overall survival (OS) and recurrence-free survival (RFS) rates were analyzed and compared between the groups. In addition, the correlation of radiological findings with pathological findings was investigated.ResultsAmong the included 347 kidneys of 340 patients, CSI was observed in 11 kidneys (3%; 95% confidence interval, 1.3–5.0%). In all the 11 kidneys, the tumors were pathologically diagnosed as clear cell RCC, and in one kidney, the tumor also had sarcomatoid features. When pathological CSI served as the standard of reference, the sensitivity, specificity, and accuracy of CSI on CT were 50%, 99.7%, and 97.1%, respectively. The OS and RFS rates were not significantly different between patients with CSI on CT and those without CSI.ConclusionThis study found that the prevalence of RCC-related CSI was 3%. Because of the low prevalence, we cannot exclude the possibility that CSI on CT would be associated with the OS and RFS. Further studies are needed to determine whether CSI on CT can be an independent prognostic factor for survival in patients with RCC.