Sureka Binit, Lal Anupam, Khandelwal N, Joshi Kusum, Singh S K, Agarwal Mayank M, Mittal Aliza
Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India.
J Cancer Res Ther. 2014 Jul-Sep;10(3):552-7. doi: 10.4103/0973-1482.137924.
Renal cell carcinoma (RCC) is by far the most common soft-tissue mass and accounts for 85% of all malignant masses of the kidney. Histopathological subtype has clinical implications in the form of prognosis and response to various newer and adjuvant treatment strategies.
The aim of this study was to evaluate the morphology and enhancement patterns of different subtypes of RCC and correlate them with their histopathological subtypes.
The study group comprised of 20 consecutive patients of RCC. The patients were evaluated with multi-detector-row computed tomography (MDCT) and Doppler ultrasound prior to surgery and findings compared with histopathological subtypes of tumor.
RCC was confirmed on histopathology. Out of 20 patients with RCC, 14 were finally diagnosed as clear cell, 4 chromophobe and 2 as papillary subtypes of RCC. None of clear-cell type showed homogenous enhancement. The mean attenuation in corticomedullary phase (CMP) and nephrographic phase (NP) for clear cell and chromophobe subtype was higher than papillary subtype, i.e. 116.1 ± 27 HU and 91.9 ± 21 HU for clear cell, 103 ± 22.4 HU and 96.2 ± 9.2 HU for chromophobe subtype and 78.5 ± 12.4 HU and 73.3 ± 12.2 HU for papillary subtype respectively. On Doppler US evaluation, non-clear-cell subtypes, which showed heterogenous enhancement on MDCT showed less color flow and peak systolic velocity (PSV). The difference in PSV and Doppler shift frequency values between clear-cell carcinoma and chromophobe subtypes were statistically significant (P = 0.003).
肾细胞癌（RCC）是目前最常见的软组织肿块，占肾脏所有恶性肿块的85%。组织病理学亚型在预后以及对各种新型辅助治疗策略的反应方面具有临床意义。
本研究的目的是评估不同亚型肾细胞癌的形态和强化模式，并将它们与其组织病理学亚型相关联。
研究组由20例连续的肾细胞癌患者组成。患者在手术前接受多排探测器计算机断层扫描（MDCT）和多普勒超声检查，并将检查结果与肿瘤的组织病理学亚型进行比较。
组织病理学确诊为肾细胞癌。在20例肾细胞癌患者中，最终确诊为透明细胞型14例，嫌色细胞型4例，乳头状亚型2例。透明细胞型均未表现为均匀强化。透明细胞型和嫌色细胞型在皮质髓质期（CMP）和肾实质期（NP）的平均衰减高于乳头状亚型，即透明细胞型在CMP和NP期分别为116.1±27HU和91.9±21HU，嫌色细胞型为103±22.4HU和96.2±9.2HU，乳头状亚型为78.5±12.4HU和73.3±12.2HU。在多普勒超声评估中，MDCT表现为不均匀强化的非透明细胞亚型显示较少的血流信号和收缩期峰值速度（PSV）。透明细胞癌和嫌色细胞亚型之间的PSV和多普勒频移值差异具有统计学意义（P = 0.003）。
