腎癌の術前評価に腎動脈造影は必要か

Abstract

1)手術により病理組織学的に局所浸潤度を確認した腎細胞癌39例において, 血管造影(とくに腎動脈造影)とCTの局所浸潤に対する正診率を検討した.2)腎動脈造影では74%(29/39), CTでは82%(27/34)の正診率が得られた.両者の間にχ2検定では有意差は認めなかった.3)腎細胞癌の局所stage診断はCTで十分であり, 腎動脈造影は不要である

The accuracy of computed tomography and arteriography for the diagnosis of local staging of renal cell carcinoma was examined in 39 patients. Their accuracy in predicting perinephric, retroperitoneal lymph node, renal vein and inferior vena caval involvement by the tumor was investigated. The results were correlated with pathologic diagnoses from specimens of nephrectomy and lymphadenectomy in 39 cases. Staging was the same as the findings of computed tomography in 82 per cent of the lesions (27 of 34) and with arteriography in 74 per cent (29 of 39). Compared to arteriography, computed tomography was more accurate in the diagnosis of regional lymph node metastases. Based upon this experience, preoperative arteriography is not routinely recommended for the diagnosis of local staging of renal cell carcinoma.