Difference Between Clinical And Pathological Stages Of PT1 Renal Carcinoma

Objective:Understand the relevant factors of the difference between the clinical and pathological stages of pTl renal cancer.Methods:The preoperative and postoperative clinical data of renal cell carcinoma patients with pathological stage pTl from January 1,2018 to January 1,2021 were collected,The preoperative imaging data and postoperative pathological data of renal cell carcinoma(RCC)patients were retrospectively analyzed.In order to reveal the difference between preoperative clinical stage and postoperative pathological stage,hierarchical analysis(XDL)was carried out based on the distance between clinical T stage,preoperative imaging,pathological type,tumor and aggregation system.Results:1.Based on the pTNM staging XDL,it can be clear:the proportion of patients in the pT1a group with over-stage cTNM is greater than that in the pTlb group,and the difference is statistically significant(χ2=50.89,P<0.001);the proportion of patients in the pTla group with under-stage cTNM is the same as that in the pTlb group In comparison,there was no statistical difference(P=0.115).2.The results of XDL based on the pathological type of RCC showed that in 165 patients with renal clear cell carcinoma(KIRC),45 patients had cTNM,>,pTNM,p= 0.001,the difference was significant.There were 2 patients with cTNM<pTNM(p=0.369),and no significant difference was found.cTNM corresponded to PtNM in 3 patients with papillary renal cell carcinoma(KIRP).There were 4 cases of chromophobe cell carcinoma(KICH),1 of which had cTNM,>pTNM(p=1.0),and there was no significant difference.1 case cTNM<pTNM,p=1.0,and the difference was not significant.6 cases of cystic renal carcinoma,1 case cTNM>pTNM,p=1.0,the difference was not significant;There were 0 patients with cTNM<pTNM.3.The results of XDL classification of patients with different examination methods showed that the proportion of patients in the urinary system color Doppler ultrasound group was higher than that in the CT group,and the difference was statistically significant(χ2=11.31,P<0.001);the CT group patients had cTNM Compared with the patients in the urinary system color Doppler ultrasound group,the proportion of under-stage staging was not statistically different(P=0.612);the difference between the image and pathological average diameters of the two inspection methods was compared and the results showed that only in the CT group patients Shows a significant difference,the difference is equal to 3.95±6.13mm,P=0.001.4.Comparative analysis of the distance between the preoperative and postoperative tumors and the collection system found that the proportion of the preoperative CT group adjacent to the collection system was higher than that of the postoperative case group,and the difference was statistically significant(χ2=18.91,P<0.001).Conclusions:1.In patients with stage T1 renal carcinoma,there was a significant difference between CT mean maximum diameter and pathological mean maximum diameter.2.Patients with PT1A stage are more likely to have high cTNM staging,which may affect the behavior of nephrosparing surgery(NSS)and prognosis evaluation in some patients.The mean CT maximum diameter of patients with Kirc is significantly larger than the pathological mean maximum diameter,which may affect the selection of NSS in some patients.Urinary pa/easier to emerging high preoperative staging in patients with stage T1 renal cancer,part may affect the choice of surgical procedure,preoperative CT showed the tumor and spacing collection system will be smaller,thus may appear high preoperative tumor staging evaluation,operation difficulty assessment is too high,NSS option for some patients may have certain influence.