XP11.2易位TFE基因融合相关性肾癌的CT表现特征及鉴别诊断
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摘要
目的 XPll.2易位TFE基因融合相关性肾癌(XPll.2/TFE肾癌)作为独立的肾癌亚型,此亚型比较罕见。文中分析XPll.2/TFE肾癌的CT表现特征,为提高诊断准确率提供参考。方法回顾性分析东部战区总医院2009年8月至2017年9月期间30例XPll.2/TFE肾癌患者的CT图像,观察分析肿瘤的部位、密度、边缘、强化及转移等特点,并与肾透明细胞癌CT图像进行对照。结果 XPll.2/TFE肾癌与肾皮质、肾髓质之间各期的CT值差异均有统计学意义(P<0.01)。本组XPll.2/TFE肾癌患者相比于ccRCC患者,发病年龄较轻[(36.4±17.7)岁vs(53.0±8.6)岁],且女性多见(70%vs 50%);肿瘤CT平扫多呈稍高密度影,CT值显著增高[(45.2±8.9)HU vs(34.1±4.4)HU],钙化出现率较高(46.7%vs 10.0%),增强扫描多呈现渐进性强化,差异均有统计学意义(P<0.05)。结论 XPll.2/TFE肾癌CT表现具有一定的特征性,结合患者临床特点有助于提高术前诊断的准确率。
Objective XPll.2/TFE RCC is an independent subtype of renal cell carcinoma,which is rare. The aim of this study is to investigate the CT features of Xp11.2/TFE RCC and improve the accuracy of diagnosis.Methods CT findings of 30 cases from August 2009 to September 2017 of Xp11.2/TFE RCC from Eastern War Zone General Hospital,including location,density,edge,enhancement degree,lymphatic metastasis and others. They were analyzed respectively and compared with those of ccRCC.Results The differences in CT values between tumors and renal cortex and renal medulla was statistically significant different phases(P< 0.01). Most of patients with Xp11.2/TFE RCC are younger,about(36.4±17.7)years old. Females are more common,accounting for about 70% compared with ccRCC(50%). CT plan scan showed slightly higher density,about(45.2±8.9)HU vs(34.1±4.4)HU,high calcification rate,about 46.7% % vs 10.0%and CT scan with contrast agent showed gradual enhancement. The difference all were statistically significant(P<0.05).Conclusion XPll.2/has certain CT characteristics. Combined with CT and clinical manifestation of patients,it is helpful to improve the accuracy of preoperative diagnosis.
Objective XPll.2/TFE RCC is an independent subtype of renal cell carcinoma,which is rare. The aim of this study is to investigate the CT features of Xp11.2/TFE RCC and improve the accuracy of diagnosis.Methods CT findings of 30 cases from August 2009 to September 2017 of Xp11.2/TFE RCC from Eastern War Zone General Hospital,including location,density,edge,enhancement degree,lymphatic metastasis and others. They were analyzed respectively and compared with those of ccRCC.Results The differences in CT values between tumors and renal cortex and renal medulla was statistically significant different phases(P< 0.01). Most of patients with Xp11.2/TFE RCC are younger,about(36.4±17.7)years old. Females are more common,accounting for about 70% compared with ccRCC(50%). CT plan scan showed slightly higher density,about(45.2±8.9)HU vs(34.1±4.4)HU,high calcification rate,about 46.7% % vs 10.0%and CT scan with contrast agent showed gradual enhancement. The difference all were statistically significant(P<0.05).Conclusion XPll.2/has certain CT characteristics. Combined with CT and clinical manifestation of patients,it is helpful to improve the accuracy of preoperative diagnosis.
引文
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[2]黄雯,季春梅,杨海伟,等.RNA结合蛋白RNPC1对肾癌细胞生物学功能的影响[J].医学研究生学报,2017,30(4):365-370.
[3]Chen X,Zhu Q,Li B,et al.Renal cell carcinoma associated with Xp11.2 translocation/TFE gene fusion:imaging findings in21 patients[J].Eur Radiol,2017,27(2):543-552.
[4]Argani P,Ladanyi M.Translocation carcinomas of the kidney[J].Clin Lab Med,2005,25:363-378.
[5]饶秋.青少年肾细胞癌分子遗传学研究进展[J].医学研究生学报,2012,25(9):967-960.
[6]高凯波,赵秀丽,叶慧义,等,Xp11.2易位/TFE3基因融合相关性肾癌的CT与MRI表现[J].中国医学影像学杂志,2017,25(3):22-226.
[7]He J,Huan Y,Qiao Q,et al.Renal carcinomas associated with Xp11.2 translocations:Are CT findings suggestive of the diagnosis?[J].Clin Radiol,2014,69(1):45-51.
[8]Dang TT,Ziv E,Weinstein S,et al.Computed tomography and magnetia resonance imaging of adult renal cell carcinoma associated with Xp11.2 translocation[J].Comput Assist Tomogr,2012,35:669-674.
[9]Koo HJ,Choi HJ,Kim MH,et al.Radiologic-pathologic correlation of renal cell carcinoma associated with Xp11.2 translocation[J].Acta Radiol,2013,54(7):827-834.
[10]He J,Gan W,Liu S,et al.Dynamic Computed Tomographic Features of Adult Renal Cell Carcinoma Associated With Xp11.2 Translocation/TFE3 Gene Fusions:Comparison With Clear Cell Renal Cell Carcinoma[J].J Comput Assist Tomogr,2015,5:730-736.
[11]Perlman EJ.Pediatric renal cell carcinoma[J].Surg Pathol Clin,2010,3:641-651.
[12]Hiroki K,Masayuki K.Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion:radiological findings mimicking papillary subtype[J].J Magn Reson Imaging,2011,33(1):217-220.
[13]Woo S,Kim SY,Lee MS,et al.MDCT Findings of Renal Cell Carcinoma Associated With Xp11.2 Translocation and TFE3Gene Fusion and Papillary Renal Cell Carcinoma[J].Ajr Am JRoentgenol,2015,204(3):542-549.