The Predictive Value Of Renal Artery Variation On Pathological Grading Of Clear Cell Renal Cell Carcinoma

Objective:Recently,studies have found that the incidence of renal artery variation in patients with RCC is higher than that in the general population.It is not clear whether there is some association between renal artery variation and the occurrence and development of renal cancer,and whether there is an effect on the pathological grade of renal cancer.The aim of this study was to observed the characteristics of renal artery variation in patients with clear cell renal cell carcinoma based visual three-dimensional models reconstructed from computed tomography images,and explored the correlation between accessory renal artery and clinicopathological features of patients,as well as the predictive factors of tumor pathological grade.The findings are expected to provide guidance for the mechanism research of occurrence and development of RCC.Methods:The clinicopathological data of patients with clear cell renal cell carcinoma diagnosed in the Department of Urology of the First Hospital of Shanxi Medical University from September 2019 to March 2023 were retrospectively analyzed.All patients underwent visual threedimensional model reconstruction from computed tomography images.1.All kidneys of patients were divided into two groups: the affected kidney and the healthy kidney.The incidence of renal artery variation,accessory renal artery,branches of renal artery before renal hilum in the two groups was analyzed.2.According to the existence of accessory renal artery in the affected kidney,the patients were divided into two groups,and the relationship between accessory renal artery and clinicopathological features of patients with clear cell renal cell carcinoma was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to determine the predictors of Fuhrman grading of clear cell renal cell carcinoma,and the predictive ability of the model was evaluated by the receiver operating characteristic curve.Results:1.The incidence of renal artery variation and accessory renal artery in the affected kidney was significantly higher than them in the healthy kidney,while the incidence of branches of renal artery before renal hilum on both sides was not significantly different.2.The patients with accessory renal artery in the affected kidney had larger tumor maximum diameter,higher Fuhrman grade and more exophytic growth.The presence of accessory renal artery on the affected kidney and the maximum diameter of tumor are independent predictors of high-grade renal cell carcinoma.The receiver operating characteristic curve suggests that the model has a good predictive ability.Conclusion:1.In patients with cc RCC,the incidence of RAV in the affected kidney was significantly higher than that in the healthy kidney.The accessory renal artery may be associated with the occurrence and development of renal cancer.2.The existence of accessory renal artery on the affected kidney may be related to the occurrence and development of clear cell renal cell carcinoma,and can better predict Fuhrman grade of clear cell renal cell carcinoma.The finding provides a reference for the future diagnostic evaluation of RCC,and provides a new direction for the study of the pathogenesis of RCC.Further studies are needed in the future to confirm these findings and to discover the underlying biological mechanisms by which accessory renal arteries may be involved in tumor development and progression.