Correlation Between Filling Deffect Patterns on Urography and Pathologic Staging of Ureteral Transitional Cell Carcinomas

雖然尿路攝影中的填影缺損是輸尿管移形細胞癌最常見的表現，但是關於填影缺損的型態與病理分期的相關性並不清楚。本研究目的是希望針對輸尿管癌不同的填影缺損型態與病理的表現加以探討。從1995年一月到2003年一月共收集了126例，病理報告證實輸尿管移形細胞癌的病例，並依據在尿路攝影中填影缺損的型態，分成四種不同的型態：卵圓型、息肉型、浸潤型、平塊型。以卡方檢定及邏輯迴歸等統計方法來分析不同的填影缺損型態與病理分期的相關性。結果在126例輸尿管癌在尿路攝影中的填影缺損表現，其中卵圓型佔22%、息肉型佔33%、浸潤型佔29%、平塊型佔15%。浸潤型和平塊型與高分期的輸尿管移型細胞癌有顯著相關；而卵圓形與息肉型則與低分期的輸尿管移形細胞癌有顯著相關。根據結果，我們認為不同的填影缺損的型態可能代表著輸尿管移形細胞癌不同的侵犯行為。各種填影缺損型態在低分期與高分期的輸尿管移形細胞癌有顯著不同的表現。輸尿管腫瘤可以根據尿路攝影中填影缺損型態的表現，作為手術前的重要參數是有助於手術前的治療計畫與腫瘤預後的預測。

關鍵字

移形細胞癌,輸尿管,尿路攝影

並列摘要

Although a filling defect within the ureter is the most common finding with ureteral transitional cell carcinomas (TCCs), little is known about the correlation between filling defect patterns and pathologic findings. This study was conducted to address this. Between January 1995 and January 2003, 126 pathologically confirmed TCCs of the ureter were included in our study. We classified urographic filling defects into four patterns: ovoid, polypoid, infiltrating, and plaque-like. The correlation between different filling defect patterns and pathologic findings was assessed using Pearson’s Chi-squared and logistic regression methods. There were 28(22%) ovoid filling defects, 42(33%) polypoid filling defects, 37(29%) infiltrating filling defects, and 19(15%) plaque-like filling defects. Infiltrating and plaque-like filling defects were significantly associated with more advanced disease compared to ovoid and polypoid filling defects (odds ratio, 6.75; 95% confidence interval, 3.04-14.98; p＜0.0001). Our results suggest that filling defect presentations may signify different invasive behavior among TCCs. The distribution of ovoid, polypoid, infiltrating, and plaque-like filling defect patterns is significantly different between superficial and advanced ureteral TCCs. We suggest that classifying the filling defect patterns of ureteral TCCs may provide important preoperative information for planning treatment and predicting outcome.

並列關鍵字

neoplasm, transitional cell carcinoma, ureter, urography

國際替代計量

Correlation Between Filling Deffect Patterns on Urography and Pathologic Staging of Ureteral Transitional Cell Carcinomas

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