摘要
目的:探讨超声造影在Xp11.2易位/TFE3基因融合相关性肾癌(简称为Xp11.2易位性肾癌)诊断中的应用价值.方法:回顾并选取2021年1月—2023年5月经病理学检查证实的Xp11.2易位性肾癌的患者作为XP组,另选取同期透明细胞肾细胞癌(clear cell renal cell carcinoma,ccRCC)作为ccRCC组,两组患者均行常规超声和超声造影检查,比较两组超声表现,并分析超声造影在Xp11.2易位性肾癌中的诊断价值.结果:纳入XP组患者28例,ccRCC组40例,XP组年龄小于ccRCC组,男性占比低于ccRCC组(χ2=5.419;χ2=7.502,P＜0.05);常规超声显示,XP组和ccRCC组在边界、钙化方面差异有统计学意义(P＜0.05);超声造影显示,XP组和ccRCC组在灌注方式、峰值增强模式方面差异有统计学意义(P＜0.05);XP组达峰时间(time to peak,TTP)、开始消退时间(begin to fade,BTF)短于ccRCC组(P＜0.05).两组到达时间(arrival time,AT)比较,差异无统计学意义(P＞0.05);采用二元logistic分析,钙化、峰值低强化或等强化增强、慢进灌注方式、TTP降低、BTF降低均为影响超声造影诊断Xp11.2易位性肾癌的独立危险因素(P＜0.05);受试者工作特征(receiver operating characteristic,ROC)曲线显示,钙化、灌注方式、峰值增强模式、TTP联合BTF诊断Xp11.2易位性肾癌的AUC为0.913,高于钙化的0.677、灌注方式的0.636、峰值增强模式的0.748、TTP的0.773、BTF的0.744(Z=4.507,Z=5.212,Z=3.674,Z=2.783;Z=3.008,P＜0.05).结论:超声造影定量参数对Xp11.2易位性肾癌具有较好的鉴别诊断效果及临床应用价值.
Abstract
Objective:To explore the application value of contrast-enhanced ultrasound in the diagnosis of Xp11.2 translocation/TFE3 gene fusion associated renal carcinoma(Xp11.2 translocation renal carcinoma).Methods:Patients with Xp11.2 translocation renal carcinoma confirmed by pathological examination were retrospectively enrolled as XP group between January 2021 and May 2023,while patients with clear cell renal cell carcinoma(ccRCC)during the same period were enrolled as ccRCC group.All patients underwent scans of routine ultrasound and contrast-enhanced ultrasound.The ultrasonographic findings in the two groups were compared.The diagnostic value of contrast-enhanced ultrasound in Xp11.2 translocation/TFE3 gene fusion-associated renal carcinoma was analyzed.Results:A total of 28 patients were included in the XP group and 40 in the ccRCC group.The age in XP group was younger than that in ccRCC group,and proportion of males was lower than that in ccRCC group(χ2=5.419;χ2=7.502,P＜0.05).Routine ultrasound showed that there were significant differences in boundary and calcification between XP group and ccRCC group(P＜0.05).Contrast-enhanced ultrasound showed that there were significant differences in perfusion mode and peak enhancement mode between XP group and ccRCC group(P＜0.05).The time to peak(TTP)and begin to fade(BTF)in XP group were shorter than those in ccRCC group(P＜0.05).There was no significant difference in arrival time(AT)between the two groups(P＞0.05).Receiver operating characteristic(ROC)curve showed that AUC of TTP combined with BTF in the diagnosis of Xp11.2 translocation renal carcinoma was 0.855,greater than that of single index(0.773,0.744;Z=2.202;Z=2.141,P＜0.05).Binary logistic analysis showed that calcification,peak low enhancement or isoenhancement,TTP≤21.15 s,BTF≤25.31 s were all independent risk factors for the diagnosis of Xp11.2 translocative renal carcinoma by contrast ultrasound(P＜0.05).Conclusion:Quantitative parameters of contrast-enhanced ultrasound have good differential diagnosis effect and clinical application value in Xp11.2 translocation renal carcinoma.
NETL
NSTL
万方数据