Value of lesion/renal cortex density ratio in differential diagnosis of renal clear cell carcinoma with enhanced CT
Objective To explore the application of lesion/renal cortex density ratio in contrast-enhanced computed tomography(CT)in the differential diagnosis of renal clear cell carcinoma(RCC).Methods A retrospective analysis was conducted on the clinical data of 100 RCC patients(RCC group)admitted to the Xuancheng Central Hospital from May 2020 to May 2023.In addition,a control study was conducted on the clinical data of 50 renal eosinophilic cell carcinoma(RO)patients(RO group)treated in the same period at our hospital.We compared the differences in lesion/renal cortex density ratios between two groups of enhanced CT scans at different stages(cortical,parenchymal,and excretory),and analyzed the diagnostic efficacy of lesion/renal cortex density ratios in RCC using receiver operating characteristic(ROC)curves.According to the classification method of the International Society of Urology,RCC patients were divided into a high-grade group of 58 cases(Grade Ⅲ 36 cases,Grade Ⅳ 22 cases)and a low-grade group of 42 cases(Grade Ⅰ 10 cases,Grade Ⅱ 32 cases).The differences in the density ratio of lesions/renal cortex in different stages of enhanced CT were compared in RCC patients with different grading levels,and the correlation between the density ratio of lesions/renal cortex in different stages of enhanced CT and the degree of disease grading was analyzed.Results The ratio of lesions/renal cortex density in the corticomedullary phase was higher than that in the parenchymal phase,and the ratio of lesions/renal cortex density in the excretory phase(all P＜0.05),and the ratio of lesions/renal cortex density in the corticomedullary phase,parenchymal phase,and excretory phase in the RCC group was higher than that in the RO group(all P＜0.05).The ROC curve analysis results showed that the area under the ROC curve(AUC)for diagnosing RCC was 0.817,0.870,and 0.773 for lesions/renal cortex density ratio in the medullary,parenchymal,and excretory phases,respectively.The AUC for combined data diagnosis of RCC was 0.896,with a sensitivity of 80.0％and a specificity of 90.0％.The density ratio of lesions/renal cortex in the high-grade group was higher than that in the low-grade group during the cortical,parenchymal,and excretory phases(all P＜0.05).Pearson correlation analysis showed that the ratio of lesion/renal cortex density in each phase of enhanced CT was positively correlated with the degree of grading(r=0.319,0.498,0.311,P＜0.05).Conclusions The ratio of lesion/renal cortex density in all stages of enhanced CT in RCC patients increases,which can be used as an effective indicator for the diagnosis of RCC.The combined diagnostic efficacy is better and closely related to the degree of grading,which can be used for clinical evaluation.
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