CT鉴别诊断儿童TFE3重排肾细胞癌与Wilms瘤

目的 观察CT鉴别诊断儿童TFE3重排肾细胞癌(TFE3 RCC)与Wilms瘤(WT)的价值。方法 回顾性分析经手术病理证实的10例单发TFE3 RCC(TFE3 RCC组)及20例单发WT(WT组)患儿的术前腹盆腔CT资料。对比组间病灶CT表现差异;针对差异有统计学意义的参数绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估其鉴别儿童TFE3 RCC与WT的效能。结果 组间CT所示病灶最大径、平扫CT净值、边界清晰与否、有无病灶内钙化、动脉期和静脉期强化CT值、强化程度差异均有统计学意义(P均＜0.05),上述各项指标鉴别诊断TFE3 RCC与WT的AUC分别为0.82、0.97、0.80、0.75、0.91、0.83及0.93。结论 CT可有效鉴别诊断儿童TFE3 RCC与WT。

CT for differential diagnosis of TFE3-rearranged renal cell carcinomas and Wilms tumor in children

Objective To investigate the value of CT for differential diagnosis of TFE3-rearranged renal cell carcinoma (TFE3 RCC) and Wilms tumor (WT) in children. Methods Preoperative abdominal pelvic CT data of 10 children with single TEF3 RCC (TFE3 RCC group) and 20 with single WT (WT group) confirmed by surgical pathology were retrospectively analyzed. CT findings of lesions were compared between groups. Receiver operating characteristic (ROC) curves of parameters being statistically different between groups were drawn, and the areas under the curve (AUC) were calculated to assess the efficacy for differentiating TFE3 RCC and WT in children. Results Statistically significant differences of the maximum diameter, net plain CT value, tumor margin clear or not, presence of intrafocal calcification or not, enhanced CT values in arterial and venous phases as well as enhancement degrees showed on CT were found between groups (all P<0.05), and AUC of the above indexes for differentiating TFE3 RCC and WT in children was 0.82, 0.97, 0.80, 0.75, 0.91, 0.83 and 0.93, respectively. Conclusion CT could effectively differentiate TFE3 RCC and WT in children.