透明细胞肾细胞癌：在多期 MDCT 上识别 20 号染色体获得。

Clear cell renal cell carcinoma: identifying the gain of chromosome 20 on multiphasic MDCT.

机构信息

The Department of Radiology, David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA, 90095-7437, USA.

The Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

出版信息

Abdom Radiol (NY). 2016 Nov;41(11):2175-2181. doi: 10.1007/s00261-016-0813-9.

DOI:10.1007/s00261-016-0813-9

PMID:27315079

Abstract

PURPOSE

To investigate whether multiphasic multidetector computed tomography (MDCT) enhancement can help identify the gain of chromosome 20 in clear cell renal cell carcinomas (RCCs), a rare prognostically significant cytogenetic abnormality.

METHODS

With the Institutional Review Board approval, we queried our institution's pathology database to derive a cohort of 52 cases of clear cell RCC with preoperative four-phase renal mass protocol MDCT and karyotypes of the resected specimens during a 10-year period. Each lesion was evaluated for absolute and relative (compared to contralateral normal renal cortex) attenuations in each phase. Relative attenuation was calculated as [(lesion attenuation - cortex attenuation)/cortex attenuation] × 100. The absolute and relative attenuations were compared using t-tests.

RESULTS

Clear cell RCCs with the gain of 20 had significantly less nephrographic and excretory phase enhancement than clear cell RCCs without the gain of 20 (86.4 HU vs. 111.4 HU, p = 0.007; 70.0 HU vs. 89.4 HU, p = 0.003; respectively). Additionally, the relative nephrographic and excretory phase attenuations of clear cell RCCs with the gain of 20 were significantly less than that of clear cell RCCs without the gain of 20 (-52.7 vs. -34.7, p = 0.002; -44.9 vs. -31.1, p = 0.005; respectively).

CONCLUSION

Multiphasic MDCT enhancement may assist in identifying the gain of chromosome 20 in clear cell RCCs, if validated in a large prospective trial.

摘要

目的

探讨多期多层 CT 增强扫描（MDCT）能否有助于识别肾透明细胞癌（RCC）中 20 号染色体获得这一罕见的具有预后意义的细胞遗传学异常。

方法

经机构审查委员会批准，我们检索了本机构的病理学数据库，以获取 10 年间行术前四期肾肿块 MDCT 检查及切除标本核型分析的 52 例肾透明细胞癌病例。对每个病变在各期的绝对衰减和相对衰减（与对侧正常肾皮质相比）进行评估。相对衰减的计算公式为[(病变衰减-皮质衰减)/皮质衰减]×100。使用 t 检验比较绝对衰减和相对衰减。

结果

与未获得 20 号染色体的肾透明细胞癌相比，获得 20 号染色体的肾透明细胞癌的肾实质期和排泄期增强程度显著降低（86.4 HU 比 111.4 HU，p=0.007；70.0 HU 比 89.4 HU，p=0.003）。此外，获得 20 号染色体的肾透明细胞癌的相对肾实质期和排泄期衰减值也明显低于未获得 20 号染色体的肾透明细胞癌（-52.7 比-34.7，p=0.002；-44.9 比-31.1，p=0.005）。