肾细胞癌假包膜的MRI表现及在肿瘤剜除术中的意义
发布时间：2019-01-17 13:35
【摘要】：目的:探讨磁共振各序列显示肾细胞癌(RCC)假包膜的差异及假包膜在肿瘤剜除手术中的意义。方法:收集我院2012年10月~2014年1月46例肾脏非囊性肿瘤患者临床资料,男27例,女19例,年龄25~76岁,平均47岁。肿瘤位于左侧22例,右侧24例。所有患者术前均行MRI检查,观察假包膜的MRI各序列表现,并与病理对照,评价磁共振成像各序列显示RCC假包膜的敏感性和特异性,并分析RCC组织学类型、分级及临床分期对假包膜完整性的影响,数据分析采用卡方检验。结果:T1WI、T2WI、T2抑脂、T1增强显示RCC假包膜的敏感性分别为43.8%、87.5%、50.0%、43.8%,差异具有统计学意义(χ2=8.635,P=0.035);特异性分别为53.8%、80.8%、38.5%、46.2%,差异有统计学意义(χ2=10.676,P=0.014)。病理显示肾透明细胞癌的假包膜完整率40.6%,乳头状腺癌假包膜完整率30.0%,两者比较差异无统计学意义(χ2=0.53,P=0.817);高分化RCC包膜完整率达56.5%,中、低分化RCC假包膜完整率仅15.8%,差异有统计学意义(χ2=7.32,P=0.007);Ⅰ期、Ⅱ期、Ⅲ+Ⅳ期RCC的包膜完整率分别为61.1%、30.8%、9.0%,差异有统计学意义(χ2=9.013,P=0.011)。结论:RCC假包膜在MRI的常规T2加权像上显示最为敏感,若术前MRI显示肿瘤周围存在完整假包膜,预示着肿瘤分化较好,临床分期较低,已经发生癌细胞局部扩散及远处转移的可能性较小,提示肿瘤剜除术的可行性。
[Abstract]:Objective: to investigate the difference of (RCC) pseudocapsule in different MRI sequences and the significance of pseudocapsule in tumor enucleation. Methods: the clinical data of 46 patients with renal non-cystic tumor from October 2012 to January 2014 were collected. There were 27 males and 19 females, aged 2576 years with an average of 47 years. The tumor was located on the left in 22 cases and on the right in 24 cases. All patients were examined with MRI before operation. The MRI sequences of pseudocapsule were observed and compared with pathology. The sensitivity and specificity of RCC pseudocapsule were evaluated and the histological types of RCC were analyzed. The effect of grade and clinical stage on the integrity of false capsule was analyzed by chi-square test. Results: the sensitivity of T _ 1WI ~ T _ 2WI T _ 2 and T _ 1 enhancement in displaying RCC pseudocapsule were 43.8% and 87.5%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (8.635) P ~ (0.035). The specificity was 53.8% and 80.8%, 38.5% and 46.2%, respectively. The difference was statistically significant (蠂 ~ 2 = 10.676). The rate of pseudocapsule integrity was 40.6 in renal clear cell carcinoma and 30.0 in papillary adenocarcinoma. There was no significant difference between the two groups (蠂 ~ 2 ~ (2) 0.53). The complete rate of well-differentiated RCC capsule was 56.5%, while that of poorly differentiated RCC was only 15.8.The difference was statistically significant (蠂 ~ 2 + 7.32% P ~ (0.007). The complete rate of RCC in stage 鈪，
本文编号：2410109
[Abstract]:Objective: to investigate the difference of (RCC) pseudocapsule in different MRI sequences and the significance of pseudocapsule in tumor enucleation. Methods: the clinical data of 46 patients with renal non-cystic tumor from October 2012 to January 2014 were collected. There were 27 males and 19 females, aged 2576 years with an average of 47 years. The tumor was located on the left in 22 cases and on the right in 24 cases. All patients were examined with MRI before operation. The MRI sequences of pseudocapsule were observed and compared with pathology. The sensitivity and specificity of RCC pseudocapsule were evaluated and the histological types of RCC were analyzed. The effect of grade and clinical stage on the integrity of false capsule was analyzed by chi-square test. Results: the sensitivity of T _ 1WI ~ T _ 2WI T _ 2 and T _ 1 enhancement in displaying RCC pseudocapsule were 43.8% and 87.5%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (8.635) P ~ (0.035). The specificity was 53.8% and 80.8%, 38.5% and 46.2%, respectively. The difference was statistically significant (蠂 ~ 2 = 10.676). The rate of pseudocapsule integrity was 40.6 in renal clear cell carcinoma and 30.0 in papillary adenocarcinoma. There was no significant difference between the two groups (蠂 ~ 2 ~ (2) 0.53). The complete rate of well-differentiated RCC capsule was 56.5%, while that of poorly differentiated RCC was only 15.8.The difference was statistically significant (蠂 ~ 2 + 7.32% P ~ (0.007). The complete rate of RCC in stage 鈪，
本文编号：2410109
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