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Xp11.2易位/TFE3基 因融合相关性肾癌 的CT表现

作者:陈 涛1 孟小丽2 任转琴1 范 晴1 李 文1

所属单位:1.陕西省宝鸡市中心医院医学影像 科 (陕西 宝鸡 721008) 2.陕西中医药大学医学技术学院 (陕西 咸阳 712046)

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摘要

目的 分析Xp11.2易位/TFE3 基 因 融 合 相 关 性 肾 癌 ( r e n a l c e l l carcinoma associated with XP11.2 translocation/TFE gene fusion, Xp11.2/TFE RCC)的CT影像特点,提高诊 断水平。方法 回顾性分析7例Xp11.2易位 性肾癌的CT资料,观察肿瘤的部位、大 小、形态、密度、强化程度、包膜、肾周 组织侵犯及淋巴结转移等特点。结果 平 扫6例呈稍高密度,1例稍低密度;3例瘤 体内见大片出血及坏死,5例可见点状钙 化;增强扫描肿瘤皮质期中等强化,髓质 期强化程度最高,肾盂期逐渐下降且低于 皮质期的强化程度,皮质期及髓质期强化 程度均低于肾皮质而高于肾髓质,肾盂期 强化低于肾髓质。结论 Xp11.2易位性肾 癌CT扫描有一定的特征性表现,有助于与 其他肾癌亚型鉴别。

Objective To investigate the CT image features of renal cell carcinoma associated with XP11.2 translocation/TFE gene fusion (Xp11.2/TFE RCC) and improve the accuracy of diagnosis. Methods CT data of seven cases Xp11.2/TFE RCC were analyzed retrospectively, the tumors' locations, sizes, shapes, densities, enhancement degrees, envelopes, perirenal tissue invasions and lymphatic metastasis, and other features, were observed respectively. Results Plain scans in 6 cases showed slightly high density and one case showed slightly hypodense in tumor, 3 cases showed extensive hemorrhage and necrosis in interior of the tumor and 5 cases showed calcification dots within it.In enhanced scans, all the cases showed moderate enhancement in renal cortex phase, the enhance degree of corticomedullary phase was the highest and excretory phase was lowest among cortex phase scans. Furthermore, the enhance degree of renal cortex phase and corticomedullary phase were both inferior to the renal cortex and exceeded in medulla kidney. The enhance degree of excretory phase was lower than medulla kidney. Conclusion Xp11.2/TFE RCC has certain CT characteristics which is conductive to identify subtypes of other renal cell carcinoma.

【关键词】肾癌;Xp11.2易位;TFE3基因 融合

【中图分类号】R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.10.032

前言

Xp11.2易位/TFE3基因融合相关性肾癌(简称Xp11.2易位性肾癌)是 一种罕见的肾脏恶性肿瘤,因其具有独特的病理特点和生物学行为, 2004年被世界卫生组织(WHO)分为肾细胞癌一个独立亚型[1]。目前关于 XP11.2易位性肾癌的影像学报道少见。笔者回顾分析经手术病理证实 的7例Xp11.2易位性肾癌的CT资料,并复习相关文献,旨在提高临床及 影像医师对该病的认识,以助于术前诊断。