Clinical study of centrality index in predicting the postoperative pathological nuclear grade of clear cell renal cell carcinoma.

OBJECTIVE

This study aimed to investigate whether the centrality index score (C index) can be used to predict the histological nuclear grade of clear cell renal cell carcinoma (ccRCC) and guide the clinical treatment of this disease.

METHODS

This study included 194 patients with ccRCC who underwent renal surgery at our center between 2016 and 2020 and had complete computed tomography or computed tomography angiography (CT/CTA) data and C index. The relationship between the pathological grade of renal masses and the C index was evaluated.

RESULTS

In univariate analysis, the gender, body mass index (BMI), tumor size, or height from the center of the renal hilum to the maximum diameter of the tumor along the 90° vertical axis (in cm) is y. The horizontal distance from the reference point of the central axis of the renal hilum to the tumor center is x. The distance from the center of the kidney to the center of the tumor is c and the C index was significantly correlated with postoperative tumor grade (p < 0.05). Multivariate analysis showed that tumor size and C index were independent prognostic factors for the preoperative prediction of the pathological grade factor of ccRCC. The receiver operating characteristic curves of the multi-parameter regression model [0.9471, 95% confidence interval (95% CI) 0.9138-0.9803], C index (0.9324, 95% CI 0.8899-0.9748), and tumor size (0.9307, 95% CI 0.8951-0.9663) were compared.

CONCLUSION

Tumor size and C index were independent prognostic factors for high-grade pathology, and large tumors and small C index were associated with high-grade pathology. Therefore, the C index can help urologists make treatment decisions.