目的:本研究旨在分析CT扫描参数联合血清畸胎瘤源性生长因子-1(Cripto-1)在肾细胞癌(RCC)诊断中的临床价值。
方法:对我院2020年7月至2022年12月收治的256例肾肿瘤患者进行回顾性分析。根据最终病理结果分为恶性组(n=180)和良性组(n=76)。所有受试者均接受CT扫描和血清Cripto-1测试。分析患者的CT征象和血清Cripto-1水平,并对其诊断效能进行评价。
结果:病理诊断结果显示180例恶性肿瘤,包括73例透明细胞癌,乳头状肾细胞癌60例,嫌色细胞癌47例,良性肿瘤76例,其中肾血管平滑肌脂肪瘤31例,嗜酸性粒细胞性肿瘤25例,肾纤维瘤20例。恶性组囊性坏死的发生率明显较高,不均匀增强和快速进展优于良性组(p<0.01)。两组患者钙化发生率差异无统计学意义(p>0.05)。恶性组病灶CT值较低(p<0.01),肾皮质相对校正CT值较低(p<0.05),血清Cripto-1水平明显高于恶性组(p<0.01)。联合诊断的曲线下面积明显高于单用血清Cripto-1和综合诊断的CT参数(P联合诊断vs血清Cripto-1<0.001,P联合诊断vs综合诊断的CT参数=0.002)。联合诊断的敏感性也高于单独的血清Cripto-1和CT参数。
结论:CT扫描参数与血清Cripto-1联合诊断肾肿瘤有较高的价值,曲线下面积和联合诊断的敏感性较高。该工作为肾肿瘤的临床诊断和治疗提供参考。
OBJECTIVE: This study aims to analyse the clinical value of computed tomography (CT) scanning parameters combined with serum teratoma-derived growth factor-1 (Cripto-1) in the diagnosis of renal cell carcinoma (RCC).
METHODS: A retrospective analysis was conducted on 256 patients with renal tumour admitted to our hospital from July 2020 to December 2022. They were divided into malignant group (n = 180) and benign group (n = 76) based on the final pathological results. All subjects underwent CT scans and serum Cripto-1 testing. The CT signs and serum Cripto-1 levels of the patients were analysed, and their diagnostic efficacy was evaluated.
RESULTS: The pathological diagnosis results showed 180 cases of malignant tumours, including 73 cases of clear cell carcinoma, 60 cases of papillary RCC and 47 cases of chromophobe cell carcinoma as well as 76 cases of benign tumour, including 31 cases of renal angiomyolipoma, 25 cases of eosinophilic tumour and 20 cases of renal fibroma. The malignant group had significantly higher incidence of cystic necrosis, uneven enhancement and rapid progression than the benign group (p < 0.01). The incidence of calcification was not statistically different between the two groups (p > 0.05). The malignant group had lower CT value of focus (p < 0.01) and relative corrected CT value of the renal cortex (p < 0.05), and significantly higher serum levels of Cripto-1 (p < 0.01) than the malignant group. The area under the curve of the combined diagnosis was significantly higher than that of serum Cripto-1 alone and comprehensive diagnosis of CT parameters (pcombined diagnosis vs serum Cripto-1 < 0.001, pcombined diagnosis vs comprehensive diagnosis of CT parameters = 0.002). The sensitivity of the combined diagnosis was also higher than that of serum Cripto-1 and CT parameters alone.
CONCLUSIONS: The combination of CT scanning parameters and serum Cripto-1 has high value in the diagnosis of renal tumours, and the area under the curve and sensitivity of the combined diagnosis are high. This work provides reference for clinical diagnosis and treatment of renal tumours.