(NDP04) The pattern of calcification can predict the type of malignancy in upper urinary tract
  • 2015-11-27,
  • 上傳者: TUA人資客服組,
  •  0
1童綜合醫院泌尿外科     2台中榮民總醫院泌尿外科
The pattern of calcification can predict the type of malignancy in upper urinary tract  
Li-Hua Huang1, Chuan-Shu Chen2,Yen-Chuan Ou2
1Divisions of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital
2Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan;
Purpose: In upper urinary tract (UUT), squamous cell carcinoma(SCC) and urothelial carcinoma (UC) are two different disease in its etiology, incidence and prognosis. I contrast to UC, the development  SCC is believed to be more related to chronic inflammation of urothelial epithelium secondary to renal calculi. In this study, we investigated the relationship between calcification pattern and squamous neoplasm in upper urinary tract.    
Materials and Methods: The study was approved by institutional review board. From 2000 to 2007, there are 373 patients with localized upper urinary tract malignancy receiving radical nephroureterectomy with bladder cuff excision (RNU) at Taichung Veterans General Hospital. Only patients having UC, UC with squamous differentiation (SqD) and SCC were enrolled. These patients’ clinical and pathologic data were retrospectively reviewed. The calcification pattern in tumors was analyzed by computer tomography(CT). Among these, 62 patients’ preoperative CT films were lost and they were excluded from the study. Finally, there were 232 pure UC, 24 UC with SqD and 9 pure SCC(2.7%) patients. The differences of calcification pattern were analyzed by Fisher’s exact test and chi- square test (Categorical variables). Continuous variables were asscssed by Mann-Whitney-U (two categories) and Kruskal-Wallis tests (three categories).
Results: Computer tomography shows the rates of calcification change are 7.8% (18/232), 25.0% (6/24) and 55.6% (5/9) in UC, SqD and SCC, respectively. In SCC, the calcification tends to be bigger, and more numerous. In addition, all SCC patients had multifocal distribution of calcification while SqD and UC patients often had single calcification. 
Conclusions: We can predict the type of tumor in upper urinary tract according to the calcification pattern at CT. When CT revealed multiple, dispersive and bigger calcification in the tumor, squamous cell carcinoma should be considered and the surgical field should be more extended.
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