Clinical study of CTU simple score in differential diagnosis of renal parenchymal infiltrating renal pelvis carcinoma and renal pelvis infiltrating renal cell carcinoma
To explore the difference of imaging manifestations between renal parenchymal infiltrating urothelial carcinoma (renal pelvis carcinoma) and renal pelvis infiltrating renal cell carcinoma (renal cell carcinoma) in multi-slice spiral computed tomography urography (CTU)
and to impr
ove the accuracy of preoperative diagnosis.
Methods:
The clinical data of 78 patients with renal pelvis carcinoma and renal cell carcinoma diagnosed after operation were retrospectively analyzed. Before operation
all patients underwent 64-slice spiral CT plain scan and three-phase enhanced scan in Beijing Friendship Hospital Affiliated to Capital Medical University. The research indicators included: gender
age
hematuria
and the characteristics of tumors in CTU [tumor location
tumor length
enhancement degree of plain scan and enhancement
whether hydronephrosis
tumor contour protrusion
kidney volume enlargement
filling defect in renal pelvis (calyces) that can be enhanced
and stones]. Comparing the differences between the two groups
the statistically significant indicators were analyzed by logistic regression
independent risk factors were screened
a simple scoring model was established
and the diagnostic efficiency of the scoring system was calculated by receiver operating characteristic (ROC) curve.
Results:
There were significant differences between the two groups in enhancement degree
hydronephrosis
protruding tumor contour
enlarged kidney volume
tumor in renal pelvis (calyces)
hematuria
and calculus (P<0.05). Among them
hydronephrosis
enlargement of kidney volume
tumor in renal pelvis (calyces)
hematuria and calculus areindependent risk factors for renal pelvis cancer. Each item is given 0 or 1 to form a CTU simple scoring system
with a total score of 0~5. With 3 as a parameter
preoperative diagnosis of renal pelvis cancer has the highest efficiency. The sensitivity is 0.919
the specificity is 0.829 and the accuracy is 0.872.
Conclusion
CTU simple score is helpful to distinguish intrarenal transitional cell carcinoma from central renal cell carcinoma