Department of Urology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Sci Rep. 2017 Jun 6;7(1):2853. doi: 10.1038/s41598-017-03135-8.
The present study aimed to assess the impact of peritumoral artery characteristics on renal function outcome prediction using a novel Peritumoral Artery Scoring System based on computed tomography arteriography. Peritumoral artery characteristics and renal function were evaluated in 220 patients who underwent laparoscopic partial nephrectomy and then validate in 51 patients with split and total glomerular filtration rate (GFR). In particular, peritumoral artery classification and diameter were measured to assign arteries into low, moderate, and high Peritumoral Artery Scoring System risk categories. Univariable and multivariable logistic regression analyses were then used to determine risk factors for major renal functional decline. The Peritumoral Artery Scoring System and four other nephrometry systems were compared using receiver operating characteristic curve analysis. The Peritumoral Artery Scoring System was significantly superior to the other systems for predicting postoperative renal function decline (p < 0.001). In receiver operating characteristic analysis, our category system was a superior independent predictor of estimated glomerular filtration rate (eGFR) decline (area-under-the-curve = 0.865, p < 0.001) and total GFR decline (area-under-the-curve = 0.796, p < 0.001), and split GFR decline (area-under-the-curve = 0.841, p < 0.001). Peritumoral artery characteristics were independent predictors of renal function outcome after laparoscopic partial nephrectomy.
本研究旨在评估基于 CT 血管造影的新型肿瘤周动脉评分系统对肾功能结果预测的影响。对 220 例行腹腔镜部分肾切除术的患者进行了肿瘤周动脉特征和肾功能评估，然后在 51 例行分割和总肾小球滤过率（GFR）的患者中进行验证。特别是，测量肿瘤周动脉分类和直径，将动脉分为低、中、高肿瘤周动脉评分系统风险类别。然后使用单变量和多变量逻辑回归分析确定主要肾功能下降的危险因素。使用接收者操作特征曲线分析比较了肿瘤周动脉评分系统和其他四个肾脏计量系统。肿瘤周动脉评分系统在预测术后肾功能下降方面明显优于其他系统（p<0.001）。在接收者操作特征分析中，我们的分类系统是肾小球滤过率（eGFR）下降（曲线下面积=0.865，p<0.001）和总 GFR 下降（曲线下面积=0.796，p<0.001）以及分割 GFR 下降（曲线下面积=0.841，p<0.001）的独立预测因子。肿瘤周动脉特征是腹腔镜部分肾切除术后肾功能结果的独立预测因子。
