肾透明细胞癌不同CT影像学征象对患者术后康复情况的影响

目的探究肾透明细胞癌不同CT影像学征象对患者术后康复情况的影响。方法选取2010年1月到2014年4月我院收治的50例肾透明细胞癌患者的CT征象,进行T分期,并分析不同CT征象与患者预后关系。结果利用CT征象进行T分期区别主要在T3a期,T3a期分为T3a-CT(10例)和T3a-仅病理(6例),T3a-仅病理CT分期可分为T1期2例,T2期4例;单因素分析显示,肿瘤大小、肿瘤是否侵及肾被膜外、是否侵及肾窦集合系统、是否侵及肾静脉及分支、是否侵及下腔静脉、有无广泛性坏死、是否存在囊性改变、瘤周是否受侵、瘤周是否存在新生血管与5年生存率具有一定相关性(P<0.05);多因素回归分析显示,肿瘤≥7cm、肿瘤穿透肾被膜、肾静脉及分支受侵、下腔静脉受侵、肿瘤无囊变、瘤周受侵及瘤周新生血管是影响肾透明细胞癌预后的独立危险因素(P<0.05)。结论肾透明细胞瘤患者肿瘤大于7cm、肿瘤穿透肾被膜、肾静脉及分支受侵、下腔静脉受侵、肿瘤无囊变、瘤周受侵及瘤周新生血管是影响肾透明细胞癌预后的独立危险因素,肿瘤周围受侵及瘤周新生血管形成可降低患者5年生存率,而肿瘤囊变可作为预测术后康复情况较好的标志之一。

Effect of Different CT Imaging Features of Renal Clear Cell Carcinoma on Postoperative Rehabilitation

Objective To investigate the effect of different CT imaging features of renal clear cell carcinoma on postoperative rehabilitation.Methods The CT signs of 50 patients with renal clear cell carcinoma admitted to a hospital from January 2010 to April 2014 were selected for T staging,and the relationship between different CT signs and patient prognosis was analyzed.Results The difference of T-staging by CT signs was in T3a stage,composed of T3a-CT(10 cases)and T3a-only pathology(6 cases).T3a-only pathological CT stage could be divided into T1 stage(2 cases)and T2 stage(4 cases).Univariate analysis showed that the size of the tumor,whether the tumor invaded the renal capsule,whether it invaded the renal sinus collection system,whether it invaded the renal vein and branches,whether it invaded the inferior vena cava,presence of extensive necrosis,cystic changes,whether the peri-tumor was invaded,and presence of new blood vessels in the peri-tumor were associated with the 5-year survival rate(P<0.05).Multivariate regression analysis showed that the tumor over 7 cm,the tumor penetrating renal capsule,renal vein and branch invasion,inferior vena cava invasion,tumor cystic change,peritumoral invasion and peritumoral neovascularization were independent risk factors affecting the prognosis of renal clear cell carcinoma(P<0.05).Conclusion The tumor over 7 cm,the tumor penetrating renal capsule,renal vein and branch invasion,inferior vena cava invasion,tumor cystic change,peritumoral invasion and peritumoral neovascularization were independent risk factors affecting the prognosis of renal clear cell carcinoma are independent risk factors affecting the prognosis of renal clear cell carcinoma.Invasion around the tumor and neovascularization of the peritumor can reduce the 5-year survival rate in patients,and tumor cystic change can be used as the indicator of better recovery after postoperative rehabilitation.