多模态影像技术联合对TFE3重排肾细胞癌诊断价值的研究
A Study on the Diagnostic Value of Combined Multimodal Imaging Techniques for TFE3-Rearranged Renal Cell Carcinoma
DOI: 10.12677/md.2026.165075, PDF,    科研立项经费支持
作者: 陈梓坤：济宁医学院医学影像与检验学院，山东 济宁；济宁市第一人民医院放射科，山东 济宁；于永梅*, 张 恒：济宁市第一人民医院放射科，山东 济宁
关键词: TFE3重排肾细胞癌；体层摄影术；磁共振成像；彩色多普勒超声；TFE3-Rearranged Renal Cell Carcinoma； Tomography； Magnetic Resonance Imaging； Color Doppler Ultrasound
摘要: 目的：探讨多模态影像技术联合对TFE3重排肾细胞癌的临床应用价值。方法：回顾性分析济宁市第一人民医院2018年1月~2025年11月经手术病理证实TFE3重排肾细胞癌患者15例，其中13例行多层螺旋CT平扫及增强检查，8例行MRI平扫及增强检查，10例行彩色多普勒超声检查，总结临床及多模态影像特征。结果：病灶位于左肾7例，右肾8例。超声：高回声3例，中等回声1例，低回声3例，混杂回声3例。CDFI均可见血流信号。CT：低密度2例，混杂密度11例；增强扫描：明显不均匀强化4例，轻中度强化6例，强化不明显3例。MRI：T1WI呈低信号、T2WI呈高信号3例，呈混杂信号2例，均呈低信号3例，DWI多呈高信号，ADC降低8例，增强方式与CT相近。病理检查：实性7例，囊实性8例；切面灰白6例，灰黄5例，灰红4例；肿瘤由嗜酸性细胞或透明细胞构成的乳头状及腺泡状结构。结论：多模态影像技术联合能更全面地反映病灶的临床和影像特征，具有临床应用价值。
Abstract: Objective: To explore the clinical application value of combined multimodal imaging for TFE3‑rearranged renal cell carcinoma. Methods: A retrospective analysis was conducted on 15 patients with TFE3-rearranged renal cell carcinoma confirmed by surgical pathology in Jining No.1 People's Hospital from January 2018 to November 2025. Among them, 13 patients underwent plain and contrast-enhanced multi-slice spiral CT (MSCT) examination, 8 patients underwent plain and contrast-enhanced magnetic resonance imaging (MRI) examination, and 10 patients underwent color Doppler ultrasound examination; the study summarized clinical and multimodal imaging features. Results: The lesions were located in the left kidney in 7 cases and the right kidney in 8 cases. Ultrasound results showed that 3 lesions presented with hyperechogenicity, 1 with intermediate echogenicity, 3 with hypoechogenicity, and 3 with mixed echogenicity; CDFI could detect blood flow signals in all lesions. CT results showed that 2 lesions presented with low density, 11 with mixed density; the enhanced scan showed that 4 lesions had obvious heterogeneous enhancement, 6 had mild to moderate enhancement, and 3 had insignificant enhancement. MRI results showed that 3 cases presented with low signal on T1WI and high signal on T2WI, 2 lesions presented with mixed signal intensity, and another 3 cases presented with low signal on both T1WI and T2WI; DWI mostly showed high signal intensity; ADC values were reduced in 8 cases. The enhancement method is similar to that of CT. Pathological examination results showed that: gross specimen observation revealed 7 solid lesions and 8 cystic-solid lesions; in terms of cut surface color, 6 were grayish-white, 5 were grayish-yellow, 4 were grayish-red; microscopic observation showed that the tumor tissue was composed of eosinophilic cells or clear cells, presenting papillary and acinar structures. Conclusion: Combined multimodal imaging techniques can more comprehensively reflect the clinical and imaging features of lesions and have clinical application value.
文章引用：陈梓坤, 于永梅, 张恒. 多模态影像技术联合对TFE3重排肾细胞癌诊断价值的研究[J]. 医学诊断, 2026, 16(5): 578-585. https://doi.org/10.12677/md.2026.165075

参考文献

[1] de Jong, B., Molenaar, I.M., Leeuw, J.A., Idenberg, V.J.S. and Oosterhuis, J.W. (1986) Cytogenetics of a Renal Adenocarcinoma in a 2-Year-Old Child. Cancer Genetics and Cytogenetics, 21, 165-169.
https://doi.org/10.1016/0165-4608(86)90042-7
[2] Lopez-Beltran, A., Scarpelli, M., Montironi, R. and Kirkali, Z. (2006) 2004 WHO Classification of the Renal Tumors of the Adults. European Urology, 49, 798-805.
https://doi.org/10.1016/j.eururo.2005.11.035
[3] Moch, H., Cubilla, A.L., Humphrey, P.A., Reuter, V.E. and Ulbright, T.M. (2016) The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part A: Renal, Penile, and Testicular Tumours. European Urology, 70, 93-105.
https://doi.org/10.1016/j.eururo.2016.02.029
[4] Moch, H., Amin, M.B., Berney, D.M., Compérat, E.M., Gill, A.J., Hartmann, A., et al. (2022) The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs—Part A: Renal, Penile, and Testicular Tumours. European Urology, 82, 458-468.
https://doi.org/10.1016/j.eururo.2022.06.016
[5] Sukov, W.R., Hodge, J.C., Lohse, C.M., Leibovich, B.C., Thompson, R.H., Pearce, K.E., et al. (2012) TFE3 Rearrangements in Adult Renal Cell Carcinoma: Clinical and Pathologic Features with Outcome in a Large Series of Consecutively Treated Patients. American Journal of Surgical Pathology, 36, 663-670.
https://doi.org/10.1097/pas.0b013e31824dd972
[6] Armah, H.B. and Parwani, A.V. (2010) Xp11.2 Translocation Renal Cell Carcinoma. Archives of Pathology & Laboratory Medicine, 134, 124-129.
https://doi.org/10.5858/2008-0391-rsr.1
[7] Achom, M., Sadagopan, A., Bao, C., McBride, F., Li, J., Konda, P., et al. (2024) A Genetic Basis for Sex Differences in Xp11 Translocation Renal Cell Carcinoma. Cell, 187, 5735-5752.e25.
https://doi.org/10.1016/j.cell.2024.07.038
[8] Chen, X., Zhu, Q., Li, B., Cui, W., Zhou, H., Duan, N., et al. (2016) Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE Gene Fusion: Imaging Findings in 21 Patients. European Radiology, 27, 543-552.
https://doi.org/10.1007/s00330-016-4421-4
[9] Ross, H. and Argani, P. (2010) Xp11 Translocation Renal Cell Carcinoma. Pathology, 42, 369-373.
https://doi.org/10.3109/00313021003767348
[10] 陈娟, 蔡迪明. Xp11.2易位/TFE3基因融合相关性肾细胞癌的超声表现[C]//中国超声医学工程学会. 中国超声医学工程学会成立四十周年暨第十四次全国超声医学学术大会论文汇编(下册). 2024: 946.
[11] Deng, L., Wang, F., Luan, Q., Liu, W., Teng, J. and Ban, Y. (2023) Ultrasound Diagnosis of Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion in Children and Adolescents. Current Medical Imaging Formerly Current Medical Imaging Reviews, 20, e200723218924.
https://doi.org/10.2174/1573405620666230720103049
[12] 王璐, 徐鹏举, 朱明明. Xp11.2易位/TFE3基因融合相关性肾细胞癌的CT/MRI表现[J]. 肿瘤影像学, 2018, 27(6): 480-483.
[13] 隋翔宇, 王文娟, 郑玉丽, 等. TFE3重排肾细胞癌的影像学表现[J]. 现代泌尿生殖肿瘤杂志, 2026, 18(3): 156-160.
[14] Lu, Y., Sun, G., Liu, X., Liu, Z., Tan, J., Hao, Y., et al. (2017) Plasma Transfusion in Patients with Cirrhosis in China: A Retrospective Multicenter Cohort Study. Transfusion Medicine Reviews, 31, 107-112.
https://doi.org/10.1016/j.tmrv.2016.11.006
[15] Guo, W., Zhu, Y., Pu, X., Guo, H. and Gan, W. (2023) Clinical and Pathological Heterogeneity of Four Common Fusion Subtypes in Xp11.2 Translocation Renal Cell Carcinoma. Frontiers in Oncology, 13, Article 1116648.
https://doi.org/10.3389/fonc.2023.1116648
[16] Qu, Y., Gu, C., Wang, H., Chang, K., Yang, X., Zhou, X., et al. (2016) Diagnosis of Adults Xp11.2 Translocation Renal Cell Carcinoma by Immunohistochemistry and FISH Assays: Clinicopathological Data from Ethnic Chinese Population. Scientific Reports, 6, Article No. 21677.
https://doi.org/10.1038/srep21677
[17] 马光明, 呼延静, 曹媛, 等. 能谱CT鉴别肾透明细胞癌和乏脂型肾血管平滑肌脂肪瘤的应用[J]. 影像诊断与介入放射学, 2018, 27(04): 278-282.
[18] 孙超, 殷凤朝, 陈延, 等. 7类不同病理亚型肾细胞癌MRI及MSCT影像学表现分析[J]. 中国CT和MRI杂志, 2022, 20(1): 132-134.
[19] 康钦钦, 田冰, 边云, 等. 基于影像特征对透明细胞肾细胞癌病理分级的预测研究[J]. 影像诊断与介入放射学, 2021, 30(2): 103-110.
[20] 张士玉, 毕海霞, 梁宗辉. 肾脏占位的诊断思维: 乳头状肾细胞癌[J]. 影像诊断与介入放射学, 2017, 26(2): 170-172.
[21] Zhang, L., Yin, Y., Chen, H., Feng, S., Liu, J., Chen, L., et al. (2020) TRIM24 Promotes Stemness and Invasiveness of Glioblastoma Cells via Activating Sox2 Expression. Neuro-Oncology, 22, 1797-1808.
https://doi.org/10.1093/neuonc/noaa138