Department of Urology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey.
Int Urol Nephrol. 2010 Dec;42(4):861-6. doi: 10.1007/s11255-010-9707-x. Epub 2010 Feb 11.
To evaluate the discrepancy between tumor sizes determined from preoperative computed tomography (CT) and surgical specimens and its clinical implications.
The charts of 86 patients who underwent surgical resection of a renal mass between 1995 and 2007 were reviewed retrospectively. Tumor size was determined both from preoperative CT and pathologic specimen. Histopathologic evaluation was done. Wilcoxon test was used to compare the mean radiographic tumor size on CT with the mean pathologic size. P < 0.05 was considered as the threshold for statistical significance.
The median age was 59 (21-84). Clinical stage was T1a in 13, T1b in 47, and ≥ T2 in 26; pathologic stage was T1a in 12, T1b in 45, and ≥ T2 in 29 patients. Histological subtype was clear cell, papillary, chromophobe, sarcomatoid, and oncocytic in 72, 7, 5, 1, and 1 patients, respectively. Mean radiographic and pathologic size was 6.33 and 6.43 cm, respectively (p = 0.342). On the average, radiographic measurement underestimated pathologic size by 1 mm. When subgroups of patients according to tumor size were formed as < 4, 4-7, and > 7 cm, mean radiographic size was 2.79, 5.44, and 9.57 cm, mean pathologic size was 3.47, 5.62, and 9.26 cm, respectively. In subgroups of < 4, 4-7, and > 7 cm; radiographic measurement underestimated pathologic size by 0.68 (p = 0.018) and 0.18 cm (p = 0.470) and overestimated by 0.31 cm (p = 0.454), respectively.
Overall discrepancy between radiographic and pathologic tumor sizes was 1 mm. No significant stage shift due to measurement error was detected. Our findings suggest that CT is an accurate method with which to estimate renal tumor size preoperatively.
评估术前计算机断层扫描（CT）与手术标本确定的肿瘤大小之间的差异及其临床意义。
回顾性分析 1995 年至 2007 年间接受肾肿块切除术的 86 例患者的病历。术前 CT 和病理标本均确定肿瘤大小。进行组织病理学评估。Wilcoxon 检验用于比较 CT 上的平均放射肿瘤大小和病理上的平均大小。p<0.05 被认为具有统计学意义。
中位年龄为 59 岁（21-84 岁）。临床分期为 T1a 期 13 例，T1b 期 47 例，≥T2 期 26 例；病理分期为 T1a 期 12 例，T1b 期 45 例，≥T2 期 29 例。组织学亚型分别为 72 例透明细胞、7 例乳头状、5 例嫌色细胞、1 例肉瘤样和 1 例嗜酸细胞。平均放射学和病理大小分别为 6.33cm 和 6.43cm（p=0.342）。平均而言，放射学测量值比病理值小 1mm。当根据肿瘤大小将患者分为<4cm、4-7cm 和>7cm 时，平均放射学测量值分别为 2.79cm、5.44cm 和 9.57cm，平均病理大小分别为 3.47cm、5.62cm 和 9.26cm。在<4cm、4-7cm 和>7cm 亚组中，放射学测量值分别低估了病理值 0.68cm（p=0.018）、0.18cm（p=0.470）和高估了 0.31cm（p=0.454）。
总体而言，放射学和病理肿瘤大小之间的差异为 1mm。未发现因测量误差导致的分期明显转移。我们的研究结果表明，CT 是一种术前准确估计肾肿瘤大小的方法。
