투명 신세포암의 핵 분화도 예측 인자로서 전산화단층촬영의 유용성
Effectiveness of Computed Tomography for Predicting the Nuclear Grade of Renal Cell Carcinoma
권영기, 김병훈, 박철희, 김천일, 장혁수,
소속 상세정보
권영기 ( Kwon Young-Kee )
계명대학교 의과대학 비뇨기과학교실
김병훈 ( Kim Byung-Hoon )
계명대학교 의과대학 비뇨기과학교실
박철희 ( Park Choal-Hee )
계명대학교 의과대학 비뇨기과학교실
김천일 ( Kim Chun-Il )
계명대학교 의과대학 비뇨기과학교실
장혁수 ( Chang Hyuk-Soo )
계명대학교 의과대학 비뇨기과학교실
KMID : 0358320090500100942
Abstract
Purpose:Nuclear grade is one of the independent prognostic factors for renal cell carcinoma (RCC). We investigated the effectiveness of a preoperative CT scan for predicting the nuclear grade of clear cell RCC.
Materials and Methods:We retrospectively reviewed the medical records of patients who underwent surgery for renal lesions between January 2002 and December 2007. We analyzed the pathologic and radiologic reports of 65 patients who underwent radical nephrectomy for RCC and were diagnosed with clear cell RCC. The Hounsfield unit (HU) of the area with maximum enhancement (M) and the total area of the RCC (T) were measured during CT. Ratio values by nuclear grade were calculated by using formulas (M HU/aorta HU, T HU/aorta HU) to eliminate differences between individuals.
Results:A total of 65 cases of clear cell RCCs were classified according to Fuhrman nuclear grade. Five cases were grade I, 33 were grade II, 15 were grade III, and 12 were grade IV. There was a significant difference in CT enhancement between each nuclear grade, and lower nuclear grades tended to have an increased ratio of maximum enhancement (p=0.020). Fuhrman nuclear grade was divided into two groups: low (Fuhrman grades I, II) and high (Fuhrman grades III, IV). The ratio of enhancement for the M area was significantly higher in the low Fuhrman nuclear grade group than in the high group (p=0.033).
Conclusions:CT enhancement is inversely related to the nuclear grade of clear cell RCC. This study found that measuring the area of maximum enhancement in CT may be a useful method for presuming the pathologic nuclear grade of RCC, especially when the Fuhrman nuclear grade is divided into low and high groups. (Korean J Urol 2009;50:942-946)
키워드
Renal cell carcinoma;Spiral computed tomography
원문 및 링크아웃 정보
등재저널 정보