Department of Urology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
J Endourol. 2011 Feb;25(2):311-5. doi: 10.1089/end.2010.0408. Epub 2011 Jan 15.
To avoid unnecessary surgical treatment of small renal masses (≤ 4 cm), a more accurate diagnostic method would be desirable since radiological differentiation between malignant and benign is difficult and nondiagnostic biopsies account from 9% to 37%. Optical coherence tomography (OCT) measures backscattered light versus depth, with an attenuation coefficient (μ(t)) that may vary among different histological types. We hypothesize that quantitative measurements of μ(t) using OCT can differentiate between normal renal parenchyma and renal cell carcinoma (RCC).
Both normal and tumor renal tissues (RCC) were harvested after partial or radical nephrectomy. Analysis of μ(t) was based on difference of (1) μ(t) between normal and tumor tissue across all patients and (2) μ(t) between normal and tumor tissue within individual patients.
Tissue samples of 18 patients were measured, of which 4 were excluded (urothelial carcinoma, oncocytoma, and benign lesion without normal tissue available). Of the remaining 14 patients, 8 contributed with both normal and RCC tissue and 6 with only normal or RCC tissue. Independent observation showed a significant difference between the median μ(t) of normal renal tissue (4.95 mm⁻¹) and the median μ(t) of RCC (8.86 mm⁻¹). No statistically significant difference was found when comparing the difference in μ(t) between normal renal parenchyma and RCC within individual patients.
There is a significant difference in μ(t) between normal and RCC tissue across all patients. These results overpower the lack of significant difference within individuals, encouraging further research and suggesting a possible role for OCT in the diagnostic work-up of renal masses.
为避免对直径≤4cm 的小肾肿瘤进行不必要的手术治疗，如果有一种更精确的诊断方法，那将是非常理想的，因为放射学很难区分良恶性，并且非诊断性活检的比例为 9%-37%。光学相干断层扫描（OCT）测量背向散射光与深度的关系，衰减系数（μ(t)）可能因不同的组织类型而有所不同。我们假设使用 OCT 对μ(t)进行定量测量可以区分正常肾实质和肾细胞癌（RCC）。
部分或根治性肾切除术后获取正常和肿瘤肾组织（RCC）。对μ(t)的分析基于以下两种方法：（1）所有患者正常和肿瘤组织之间的μ(t)差异，以及（2）每位患者正常和肿瘤组织之间的μ(t)差异。
共测量了 18 例患者的组织样本，其中 4 例被排除（尿路上皮癌、嗜酸细胞瘤和良性病变且无正常组织）。在剩余的 14 例患者中，8 例患者同时提供了正常和 RCC 组织，6 例患者仅提供了正常或 RCC 组织。独立观察显示，正常肾组织的中位数μ(t)（4.95mm⁻¹）与 RCC 的中位数μ(t)（8.86mm⁻¹）之间存在显著差异。在比较每位患者的正常肾组织与 RCC 之间的μ(t)差异时，未发现统计学上的显著差异。
所有患者的正常和 RCC 组织之间的μ(t)存在显著差异。这些结果超过了个体内差异无统计学意义的情况，鼓励进一步研究，并提示 OCT 在肾肿块诊断中的可能作用。
