56例肾细胞癌CT分期与手术病理对照研究

目的 :探讨肾细胞癌术前 CT分期的方法 ,提高肾细胞癌 CT分期的准确率。方法 :5 6例肾细胞癌均经手术病理证实 ,用盲法根据 CT征象判断肾包膜、肾静脉和下腔静脉、区域淋巴结及邻近器官组织的侵犯情况 ,并按 Robson分期法进行 CT分期 ,将手术病理结果与 CT分期进行对照研究。结果 :CT判断肾包膜侵犯的敏感性为 82 % ,特异性为 85 % ;静脉侵犯的敏感性 80 % ,特异性 93% ;区域淋巴结转移敏感性 91% ,特异性 88% ;邻近器官组织侵犯敏感性 86 % ,特异性 97%。 CT分期与手术病理分期总体符合率为 91%。结论 :CT是肾细胞癌术前分期的有效方法。采用薄层、动态扫描、仔细观察 CT征象 ,结合 MRI及超声检查 ,能提高肾细胞癌术前 CT分期的准确率

The Comparative Research on CT Staging and Pathology of Renal Carcinoma in 56 Cases

Objective:To expore the preoperative CT staging of renal cell carcinoma so that to improve the accuracy of CT Staging.Methods:Fifty-six cases with renal cell carcinoma were confirmed by pathological examination.The invasion of the renal capsaule,veins and the inferior vena cava,the regional lymph nodes,and the adjacent organs and tissue were assessed on the basis of CT signs by the blind method.The cases were staged by Robson staging and the results of both the operative pathological staging and the CT staging were compared and studied.Results:By CT judging the sensitivity and specificity on the invasion for the renal capsule were 82% and 85%,for the vein was 80% and 93%,for the metastasis of the regional lymph nodes was 91% and 88%,while for the adjacent organs and tissue was 86% and 97% respectively.The total coincided rate between the CT staging and the pathological staging was 91%.Conclusion:CT is useful and effective in preoperative staging for renal cell carcinoma.The use of CT thin slice technique and dynamic scan,and careful observating CT signs combined with MRI and sonography can improve the accuracy of preoperative CT staging for renal cell carcinoma.