与Xp11.2易位/TFE3基因融合相关的成人肾细胞癌的动态计算机断层扫描特征：与透明细胞肾细胞癌的比较
Dynamic Computed Tomographic Features of Adult Renal Cell Carcinoma Associated With Xp11.2 Translocation/TFE3 Gene Fusions: Comparison With Clear Cell Renal Cell Carcinoma.
作者信息
He Jian, Gan Weidong, Liu Song, Zhou Kefeng, Zhang Gutian, Guo Hongqian, Zhu Bin
机构信息
From the Departments of *Radiology and †Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
出版信息
J Comput Assist Tomogr. 2015 Sep-Oct;39(5):730-6. doi: 10.1097/RCT.0000000000000263.
OBJECTIVE
To investigate the dynamic contrast-enhanced computed tomography (CT) characteristics of renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusion (Xp11.2 RCC) by comparison with clear cell renal cell carcinoma (CCRCC).
METHODS
Dynamic contrast-enhanced CT images and clinical and pathological records of 20 adult patients with Xp11.2 RCC confirmed by TFE3 immunohistochemical and fluorescence in situ hybridization assay were retrospectively analyzed and compared with the findings of 21 contemporary CCRCCs.
RESULTS
Renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusions often occurred in young (30.6 ± 8.6 years) patients with hematuria (9/20). They presented as well-defined (17/20) cystic-solid (17/20) mass with hemorrhage (8/20) and circular/rim calcifications (6/20). Dynamic contrast-enhanced CT showed heterogeneous moderate prolonged enhancement. A tumor-to-cortex attenuation ratio in corticomedullary phase less than 0.62 gave a sensitivity of 90.0% and a specificity of 92.9% in differentiating Xp11.2 RCC from CCRCC (area under the receiver operating characteristic curve = 0.957, P < 0.001).
CONCLUSIONS
Computed tomographic characteristics and dynamic contrast-enhanced patterns and index can differentiate Xp11.2 RCC from CCRCC.
目的
通过与透明细胞肾细胞癌（CCRCC）比较，探讨Xp11.2易位及TFE基因融合相关肾细胞癌（Xp11.2 RCC）的动态对比增强计算机断层扫描（CT）特征。
方法
回顾性分析20例经TFE3免疫组化和荧光原位杂交检测确诊的成年Xp11.2 RCC患者的动态对比增强CT图像以及临床和病理记录，并与21例同期CCRCC的检查结果进行比较。
结果
Xp11.2易位及TFE基因融合相关肾细胞癌常发生于年轻患者（30.6±8.6岁），血尿发生率为9/20。表现为边界清晰（17/20）的囊实性肿块（17/20），伴有出血（8/20）和环状/边缘钙化（6/20）。动态对比增强CT显示不均匀中度延迟强化。皮质髓质期肿瘤与皮质的衰减比小于0.62，在鉴别Xp11.2 RCC与CCRCC时，敏感性为90.0%，特异性为92.9%（受试者工作特征曲线下面积=0.957，P<0.001）。
结论
计算机断层扫描特征、动态对比增强模式及指标可鉴别Xp11.2 RCC与CCRCC。
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