ISSN 1004-4140
CN 11-3017/P

CT增强定量参数预测肾透明细胞癌WHO/ISUP分级

Prediction of WHO/ISUP Grading of Renal Clear Cell Carcinoma by Quantitative Parameters of CT Enhancement Scanning

  • 摘要: 目的:探讨CT增强定量参数术前预测肾透明细胞癌(ccRCC)世界卫生组织/国际泌尿病理学会(WHO/ISUP)分级的价值。方法:连续搜集行手术治疗的98例ccRCC患者临床和CT增强资料,根据WHO/ISUP分级分为低级别组(76例)和高级别组(22例)。比较CT增强定量参数两组间差异及各参数预测ccRCC WHO/ISUP分级的诊断效能,并进行外部验证,找寻泛化能力最佳的CT增强定量参数。结果:两组间皮质期CT值、皮质期净增值、皮质期强化率、实质期CT值、实质期净增值、实质期强化率差异均有统计学意义,AUC值分别依次为0.834、0.871、0.900、0.707、0.678和0.762;截断值分别依次为123.5 HU、71 HU、0.73、87.5 HU、54 HU、0.67;皮质期强化率诊断效能最高,AUC=0.900,敏感度为0.842,特异度为0.864;外部验证结果显示皮质期强化率诊断效能(AUC=0.867)优于皮质期CT值(AUC=0.735)、皮质期净增值(AUC=0.709),Z值分别为 2.134和2.417。结论:CT增强定量参数可用于预测ccRCC WHO/ISUP分级,皮质期强化率是诊断效能最高、泛化能力最佳的CT增强定量参数。

     

    Abstract: Objective: To investigate the potential of CT-enhanced quantitative parameters for preoperative prediction of WHO/ISUP grading for renal clear cell carcinoma (ccRCC). Methods: The study involved collecting clinical and CT-enhanced data of 98 patients with ccRCC, who were then classified into low level group (76 cases) and high level group (22 cases) based on the WHO/ISUP classification. Differences in CT-enhanced quantitative parameters between the two groups were compared, and the diagnostic efficacy of each parameter for predicting ccRCC WHO/ISUP grading was evaluated. External verification was conducted to identify CT-enhanced quantitative parameters with the best generalization ability. Results: There were significant differences in the CT value, net increment, and enhancement rate in both cortical and substantive phases between the two groups. The AUC values were 0.834, 0.871, 0.900, 0.707, 0.678, and 0.762, respectively. The cut-off values were 123.5 HU, 71 HU, 0.73, 87.5 HU, 54 HU, 0.67, respectively. The diagnostic efficacy of cortical enhancement rate was the highest with an AUC of 0.900, a sensitivity of 0.842, and a specificity of 0.864. The external validation results revealed that the diagnostic efficacy of cortical phase enhancement rate (AUC=0.867) was better than that of cortical phase CT (AUC=0.735) and cortical phase net increment (AUC=0.709). The Z values were 2.134 and 2.417, respectively. Conclusion: The quantitative parameters of CT enhancement can be used to predict ccRCC WHO/ISUP grading. Cortical phase enhancement rate is the parameter with the highest diagnostic efficiency and the best generalization ability.

     

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