The Value of Predicting Postoperative Recurrence and Metastasis of Clear Cell Renal Cell Carcinoma by Extracellular Volume Fraction Based on Enhanced CT
Objective This study aims to evaluate the value of preoperative non-invasive assessment of extracellular volume fraction(ECV)using enhanced CT in predicting the recurrence and metastasis of clear cell renal cell carcinoma(ccRCC).Methods A retrospective analysis was performed on 169 patients with pathologically confirmed ccRCC.Col-lected data included age,gender,maximum tumor diameter,surgical method,pathological grade,tumor stage,systemic immune-inflammation index(SII),and preoperative ECV.Based on their outcomes,patients were divided into a recur-rence/metastasis group(n=33)and a non-recurrence/metastasis group(n=136).Univariate analyses were conducted u-sing independent sample i-tests,Mann-Whitney U tests,Fisher's exact tests,and chi-square tests.Multivariate Logistic re-gression was used to identify independent risk factors for postoperative recurrence and metastasis,and a nomogram was de-veloped based on these factors.Results Univariate analysis revealed that ECV,SII,maximum tumor diameter,patho-logical grade,and tumor stage significantly influenced postoperative recurrence and metastasis of ccRCC(P＜0.05).Mul-tivariate logistic regression analysis identified ECV,SII,pathological grade,and tumor stage as independent risk factors for recurrence and metastasis in ccRCC patients(P＜0.05).The receiver operating characteristic(ROC)curve demonstrated that the area under the curve(AUC)for predicting postoperative recurrence and metastasis of ccRCC using ECV derived from enhanced CT was 0.812.The nomogram predictive model constructed from these independent risk factors achieved an AUC value of 0.909.Conclusion ECV,SII,tumor stage,and pathological grade derived from enhanced CT can effec-tively predict the risk of postoperative recurrence and metastasis in ccRCC patients.The nomogram predictive model based on ECV and clinical factors demonstrates superior performance and can aid in developing individualized treatment plans.
维普
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