Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China.
Department of Imaging, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China.
Tumori. 2021 Feb;107(1):64-70. doi: 10.1177/0300891620935990. Epub 2020 Jun 29.
Previous reports have described several methods and markers used to distinguish pathologic subtypes of renal cell carcinoma (RCC). This study aimed to evaluate the utility of the ratio of maximum to minimum tumor diameter (ROD) in predicting pathologic subtypes of RCC.
Data from patients with RCC who underwent surgery between January 2015 and December 2019 were reviewed retrospectively. The cutoff value for ROD was calculated using receiver operating characteristic (ROC) curve analysis.
In the clear cell RCC (ccRCC) and non-ccRCC groups, the optimal ROD cutoff value to predict ccRCC was determined to be 1.201 (sensitivity, 90.7%; specificity, 76.1%; area under the ROC curve [AUC], 0.827; < 0.001). In the non-ccRCC group, the cutoff value for ROD in predicting papillary RCC was 1.092 (sensitivity, 87.9%; specificity, 40.5%; AUC, 0.637; = 0.003). Compared with patients with ROD <1.201, more patients in the ccRCC group exhibited tumors with an ROD ⩾1.201 (14.2% versus 85.8%, respectively; < 0.001). Multivariate analysis of preoperative features revealed that ROD ⩾1.201 was an independent predictive factor for ccRCC. In addition, patients with ROD ⩾1.201 had higher percentages of Fuhrman grade III/IV (91.2% versus 8.8%; = 0.014), tumor necrosis (86.7% versus 13.3%; = 0.012) and sarcomatoid differentiation (90.6% versus 9.4%; < 0.001).
ROD was a novel indicator for preoperatively predicting histologic type in patients with RCC. ROD cutoff values of 1.201 and 1.092 were the most discriminative for ccRCC and papillary RCC, respectively. Moreover, ROD ⩾1.201 was associated with high Fuhrman grade, sarcomatoid features, and tumor necrosis.
先前的报告描述了几种用于区分肾细胞癌 (RCC) 病理亚型的方法和标志物。本研究旨在评估最大与最小肿瘤直径比 (ROD) 在预测 RCC 病理亚型方面的效用。
回顾性分析了 2015 年 1 月至 2019 年 12 月期间接受手术治疗的 RCC 患者的数据。使用接收者操作特征 (ROC) 曲线分析计算 ROD 的临界值。
在透明细胞 RCC (ccRCC) 和非 ccRCC 组中，确定预测 ccRCC 的最佳 ROD 临界值为 1.201（灵敏度为 90.7%，特异性为 76.1%，ROC 曲线下面积 [AUC] 为 0.827；<0.001）。在非 ccRCC 组中，预测乳头状 RCC 的 ROD 临界值为 1.092（灵敏度为 87.9%，特异性为 40.5%，AUC 为 0.637；=0.003）。与 ROD<1.201 的患者相比，ccRCC 组中更多患者的肿瘤 ROD ⩾1.201（分别为 14.2%和 85.8%；<0.001）。术前特征的多变量分析显示，ROD ⩾1.201 是 ccRCC 的独立预测因素。此外，ROD ⩾1.201 的患者中，Fuhrman 分级 III/IV （91.2% 比 8.8%；=0.014）、肿瘤坏死（86.7% 比 13.3%；=0.012）和肉瘤样分化（90.6% 比 9.4%；<0.001）的比例更高。
ROD 是一种预测 RCC 患者组织学类型的新指标。ROC 曲线的最佳临界值为 1.201 时，最有助于鉴别 ccRCC；ROC 曲线的最佳临界值为 1.092 时，最有助于鉴别乳头状 RCC。此外，ROD ⩾1.201 与较高的 Fuhrman 分级、肉瘤样特征和肿瘤坏死相关。
