CAJ | 학술논문

目的探讨肾脏透明细胞癌患者扩散张量成像(DTI)参数与组织病理的相关性.方法回顾性分析经手术病理证实为肾脏透明细胞癌且病变最大径≥1 cm的30例患者.患者均行肾脏DTI检查,测量肾肿瘤和正常肾实质的ADC值、主特征向量(E1)值和各向异性分数(FA)值.对手术取得的病变组织行病理检查,将患者分为低级别(Ⅰ~Ⅱ级)和高级别(Ⅲ~Ⅳ级)肾透明细胞癌组,并测得肿瘤细胞密度和微血管密度(MVD).采用独立样本t检验比较高、低级别肾透明细胞癌的细胞密度和MVD,采用单因素方差分析比较正常肾组织、高级别肾透明细胞癌、低级别肾透明细胞癌的DTI参数,采用Pearson相关检验分析各DTI参数与细胞密度和MVD的相关性.结果低级别组肾透明细胞癌15例(Ⅰ级7例、Ⅱ级8例),高级别组肾透明细胞癌15例(Ⅲ级9例、Ⅳ级6例).低、高级别组的肿瘤细胞密度分别为(51.73±6.73)%和(64.87±9.08)%,低、高级别肿瘤的MVD分别为(49.33± 7.76)、(61.27±8.45)条/高倍视野,差异均有统计学意义(t值分别为-4.50和-4.03,P均<0.05).正常肾实质、低级别肾透明细胞癌和高级别肾透明细胞癌的ADC值分别为(2.08±0.10)×10-3、(1.24±0.19)× 10-3、(1.08±0.19)×10-3mm2/s,E1值分别为(2.19±0.15)×10-3、(1.44±0.16)×10-3、(1.21±0.21)×10-3mm2/s, FA分别为0.32 ± 0.05、0.29 ± 0.08、0.22 ± 0.06,不同组织间上述值差异均有统计学意义(F值分别为148.347、127.366、11.511 ,P均<0.05).ADC、E1、FA值与细胞密度间均呈负相关(r值分别为-0.796、-0.865、-0.730 ,P均<0.05);ADC、E1、FA值与MVD间均呈负相关(r值分别为-0.739、-0.826、-0.761,P均<0.05).结论 DTI参数和肾透明细胞的病理分级间具有相关性.
목적 탐토신장투명세포암환자확산장량성상(DTI)삼수여조직병리적상관성.방법 회고성분석경수술병리증실위신장투명세포암차병변최대경≥1 cm적30례환자.환자균행신장DTI검사,측량신종류화정상신실질적ADC치、주특정향량(E1)치화각향이성분수(FA)치.대수술취득적병변조직행병리검사,장환자분위저급별(Ⅰ~Ⅱ급)화고급별(Ⅲ~Ⅳ급)신투명세포암조,병측득종류세포밀도화미혈관밀도(MVD).채용독립양본t검험비교고、저급별신투명세포암적세포밀도화MVD,채용단인소방차분석비교정상신조직、고급별신투명세포암、저급별신투명세포암적DTI삼수,채용Pearson상관검험분석각DTI삼수여세포밀도화MVD적상관성.결과 저급별조신투명세포암15례(Ⅰ급7례、Ⅱ급8례),고급별조신투명세포암15례(Ⅲ급9례、Ⅳ급6례).저、고급별조적종류세포밀도분별위(51.73±6.73)%화(64.87±9.08)%,저、고급별종류적MVD분별위(49.33± 7.76)、(61.27±8.45)조/고배시야,차이균유통계학의의(t치분별위-4.50화-4.03,P균<0.05).정상신실질、저급별신투명세포암화고급별신투명세포암적ADC치분별위(2.08±0.10)×10-3、(1.24±0.19)× 10-3、(1.08±0.19)×10-3mm2/s,E1치분별위(2.19±0.15)×10-3、(1.44±0.16)×10-3、(1.21±0.21)×10-3mm2/s, FA분별위0.32 ± 0.05、0.29 ± 0.08、0.22 ± 0.06,불동조직간상술치차이균유통계학의의(F치분별위148.347、127.366、11.511 ,P균<0.05).ADC、E1、FA치여세포밀도간균정부상관(r치분별위-0.796、-0.865、-0.730 ,P균<0.05);ADC、E1、FA치여MVD간균정부상관(r치분별위-0.739、-0.826、-0.761,P균<0.05).결론 DTI삼수화신투명세포적병리분급간구유상관성.
Objective To investigate the correlation between the diffusion tensor imaging (DTI) parameters and histopathology in renal clear cell carcinoma patients.Methods Thirty renal clear cell carcinoma patients with lesions more than 1 cm in diameter were retrospectively analyzed.All patients had DTI and apparent diffusion coefficient (ADC),eigenvector 1(E1),fractional anisotropy(FA) value in normal kidney and lesion were measured respectively.The lesions were analyzed according to the Fuhrman nuclear grade for pathological findings.They were divided into two groups, namely high (Ⅲ—Ⅳ)and low (Ⅰ—Ⅱ) grade groups. In addition, the cell density,micro-vessel density (MVD) of turmor were also measured.The differences between two groups in cell density,micro-vessel density were analyzed by independent samples t test, the difference among normal kidney,high and low grade groups of clear cell renal cell carcinoma were compared using ANOVA.The correlationsamong ADC,E1,FA value and cell density, micro-vessel density were analyzed using Pearson analysis. Results Fifteen cases of renal clear cell carcinoma were of low grade (levelⅠ,8 cases, levelⅡ,7 cases), 15 cases were of high grade (levelⅢ,9 cases, levelⅣ,6 cases). The cell density of low and high grade tumors were (51.73±6.73)%, and (64.87±9.08)%respectively, the microvessel density were (49.33±7.76)/HP, and (61.27±8.45)/HP respectively. There were significant differences found(t=-4.50,-4.03,P<0.05). The ADC of normal renal tissues and low, high grade renal clear cell carcinoma were (2.08 ± 0.10) × 10-3, (1.24 ± 0.19) × 10-3, (1.08 ± 0.19) × 10-3 mm2/s respectively, the E1 value were (2.19 ± 0.15) × 10-3, (1.44 ± 0.16) × 10-3,(1.21 ± 0.21) × 10-3mm2/s,respectively, and the FA were 0.32 ± 0.05, 0.29 ± 0.08, 0.22 ± 0.06, respectively. There were significant differences in ADC,E1,FA values (F=148.347,127.366, 11.511,P<0.05). Cell density was negatively correlated to ADC,E1, FA values (r=-0.796,-0.865,-0.730;P<0.05). The correlation between ADC,E1, FA values and MVD were negatively correlated(r=-0.739,-0.826,-0.761;P<0.05). Conclusion DTI parameters are correlated with pathological classification of renal clear cell carcinoma.