Department of Urology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Sungnam, Kyunggi-do, 463-707, Korea.
World J Urol. 2010 Jun;28(3):263-7. doi: 10.1007/s00345-010-0511-0. Epub 2010 Jan 30.
We investigated the difference between tumor sizes measured via preoperative computed tomography (CT) images and in surgical specimens during pathologic examinations in a contemporary cohort of patients who received extirpative surgery for renal tumors.
We reviewed records of 467 patients who received radical or partial nephrectomy for renal lesions suspicious for malignancy. For our study, only patients who underwent preoperative CT within 4 weeks of surgery were included. In all patients, radiographic tumor size, defined as the largest diameter of tumor measured via CT images, and pathologic tumor size, the largest diameter of tumor measured in surgical specimen, were compared and analyzed by various factors.
Among total subjects, mean radiographic and pathologic tumor size were 4.56 +/- 2.99 and 4.49 +/- 3.23 cm, respectively (P = 0.399). When subjects were categorized according to radiographic tumor size (1-cm range), statistically significant difference (average of 2 mm) between radiographic and pathologic tumor size was observed only in the 4 to <5 cm range (P = 0.046). Among those with clear cell renal cell carcinoma, mean radiographic tumor size was significantly larger than pathologic size, but by only 1.4 mm (P = 0.012). Factors such as age, gender, body mass index, tumor stage, tumor grade, and tumor location were observed to have no significant impact on differences observed between radiographic and pathologic tumor size.
Although actual size of renal mass can be generally overestimated by CT images, difference may be minimal and clinically insignificant in most cases.
我们研究了在接受肾肿瘤切除术的当代患者队列中，术前计算机断层扫描 (CT) 图像测量的肿瘤大小与病理检查手术标本中的肿瘤大小之间的差异。
我们回顾了 467 例接受根治性或部分肾切除术治疗疑似恶性肾病变患者的记录。在我们的研究中，仅包括在手术前 4 周内接受 CT 检查的患者。在所有患者中，通过 CT 图像测量的肿瘤最大直径定义为放射学肿瘤大小，通过手术标本测量的肿瘤最大直径定义为病理肿瘤大小，对这两个大小进行比较，并根据各种因素进行分析。
在所有受试者中，平均放射学肿瘤大小和病理肿瘤大小分别为 4.56 +/- 2.99 cm 和 4.49 +/- 3.23 cm（P = 0.399）。当根据放射学肿瘤大小（1cm 范围）对受试者进行分类时，仅在 4 至 <5cm 范围内观察到放射学肿瘤大小与病理肿瘤大小之间存在统计学显著差异（平均为 2mm）（P = 0.046）。在透明细胞肾细胞癌患者中，平均放射学肿瘤大小明显大于病理大小，但仅为 1.4mm（P = 0.012）。年龄、性别、体重指数、肿瘤分期、肿瘤分级和肿瘤位置等因素观察到对放射学肿瘤大小与病理肿瘤大小之间观察到的差异没有显著影响。
尽管 CT 图像通常可以高估肾肿块的实际大小，但在大多数情况下，差异可能很小且无临床意义。
