Tepe Murat, Sevin Erce, Inan Ibrahim, Aktan Ahmet, Ayaz Muzaffer, Ibrahim Ali Heba, Senturk Senem
Department of Radiology, King's College Hospital London-Dubai, Dubai 50001, UAE.
Department of Radiology, Siirt Teaching and Research Hospital, Siirt 56100, Turkey.
Curr Med Imaging. 2024;20:e15734056303423. doi: 10.2174/0115734056303423241118074519.
There are variations in prognosis and therapeutic approach for renal cell carcinoma among different histological subtypes. This study aims to determine the relationship between radiologically detected peritumoral neovascularization and the histological subtypes of Renal Cell Carcinoma (RCC) and to assess whether extratumoral neovascularization characteristics detected via imaging can contribute to distinguishing these subtypes alongside tumor size and T-stage.
104 renal tumors from 104 cases consisting of 31 females (29.8%) and 73 males (70.2%) who underwent abdominal CT or MRI and received a histopathological renal cell carcinoma diagnosis were included. Out of 104 cases, 45 (43.27%) cases had a preoperative CT, 52 (50%) cases had a preoperative MRI, and 7 (6.73%) cases had both preoperative CT and MR images. The cases were categorized according to the histopathologic subtypes. The presence of the radiologically visible peritumoral vascularity and its diameter was noted in order to compare with the histopathological subtypes and other morphologic or histopathological findings, including size, presence of cystic component, T score, and Fuhrman grade of the tumor.
104 unilateral renal tumors (median size 5 cm; range 2-26 cm) were included in this study, of which 71 (68.3%) were clear cell, 20 (9.2%) were papillary and 13 (12.5%) were chromophobe renal cell carcinomas. Although the presence of peritumoral neovascularization was observed to a lesser degree in papillary carcinomas than clear cell and chromophobe carcinomas, there was no statistically significant difference among histological subtypes and between clear cell and non-clear cell carcinomas according to the frequency of peritumoral neovascularization (p = 0.16 and p = 0.084). The presence of peritumoral neovascularization was significantly associated with tumor size for all tumors and within histological subtypes (p < 0.0001). As the diameter of the tumor increased, the presence of peritumoral neovascularization increased. T stage of tumors was significantly associated with both the presence of peritumoral neovascularization and the largest peritumoral vessel diameter (p < 0.01 and p = 0.002).
No statistically significant association between the histological subtype of tumors and the frequency of peritumoral neovascularization was found in this study. The frequency of peritumoral neovascularization increased with the size and T stage of the tumor. Additionally, the largest peritumoral vessel diameter increased with the T stage of the tumor. There was no statistically significant relationship between peritumoral vascularity and Fuhrman grade.
不同组织学亚型的肾细胞癌在预后和治疗方法上存在差异。本研究旨在确定放射学检测到的肿瘤周围新生血管与肾细胞癌（RCC）组织学亚型之间的关系，并评估通过影像学检测到的肿瘤外新生血管特征是否有助于与肿瘤大小和T分期一起区分这些亚型。
纳入104例患者的104个肾肿瘤，其中女性31例（29.8%），男性73例（70.2%），均接受了腹部CT或MRI检查，并获得了肾细胞癌的组织病理学诊断。在104例患者中，45例（43.27%）术前行CT检查，52例（50%）术前行MRI检查，7例（6.73%）术前行CT和MR检查。根据组织病理学亚型对病例进行分类。记录放射学可见的肿瘤周围血管情况及其直径，以便与组织病理学亚型以及其他形态学或组织病理学结果进行比较，包括肿瘤大小、囊性成分的存在、T评分和Fuhrman分级。
本研究纳入104个单侧肾肿瘤（中位大小5 cm；范围2 - 26 cm），其中71个（68.3%）为透明细胞癌，20个（9.2%）为乳头状癌，13个（12.5%）为嫌色细胞肾细胞癌。虽然观察到乳头状癌中肿瘤周围新生血管的程度低于透明细胞癌和嫌色细胞癌，但根据肿瘤周围新生血管的频率，组织学亚型之间以及透明细胞癌和非透明细胞癌之间均无统计学显著差异（p = 0.16和p = 0.084）。对于所有肿瘤以及各组织学亚型，肿瘤周围新生血管的存在与肿瘤大小显著相关（p < 0.0001）。随着肿瘤直径的增加，肿瘤周围新生血管的存在增加。肿瘤的T分期与肿瘤周围新生血管的存在以及最大肿瘤周围血管直径均显著相关（p < 0.01和p = 0.002）。
本研究未发现肿瘤组织学亚型与肿瘤周围新生血管频率之间存在统计学显著关联。肿瘤周围新生血管的频率随肿瘤大小和T分期增加。此外，最大肿瘤周围血管直径随肿瘤T分期增加。肿瘤周围血管情况与Fuhrman分级之间无统计学显著关系。
