TY - JOUR
T1 - Association of the gross appearance of intratumoral vascularity at MDCT with the carbonic anhydrase IX score in clear cell renal cell carcinoma
AU - Young, Jonathan R
AU - Coy, Heidi
AU - Kim, Hyun J.
AU - Douek, Michael
AU - Sisk, Anthony
AU - Pantuck, Allan J.
AU - Raman, Steven S.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - OBJECTIVE. The purpose of this study was to determine whether qualitative MDCT features are associated with the carbonic anhydrase IX (CAIX) score of clear cell renal cell carcinoma (RCC). The CAIX score has been previously found to have prognostic significance for disease-free survival, overall survival, and lymph node involvement. MATERIALS AND METHODS. A cohort of 105 histologically proven clear cell RCCs in patients who underwent preoperative four-phase renal mass MDCT was derived from 2001 to 2013. Two genitourinary radiologists evaluated each lesion for the gross appearance of intratumoral vascularity, calcification, enhancement pattern, necrosis, margin, collecting system invasion, and renal vein invasion. Immunohistochemical analysis was used to determine the CAIX score (defined as the positive staining percentage multiplied by the staining intensity). Logistic and linear regression analyses were performed. RESULTS. In a linear regression model controlled for lesion size and stage, the gross appearance of intratumoral vascularity had a significant positive association with CAIX score (β = 38.33, p = 0.010). In a logistic regression model controlled for lesion size and stage, the gross appearance of intratumoral vascularity had an odds ratio of 2.85 (p = 0.019) in differentiating clear cell RCCs with a CAIX score of 200–300 from clear cell RCCs with a CAIX score of 0–199. CONCLUSION. In clear cell RCCs, the gross appearance of intratumoral vascularity at MDCT was significantly associated with CAIX score, a prognostically significant molecular marker. Current assessment of CAIX score requires pathologic tissue sampling and immunohistochemical analysis. A noninvasive imaging biomarker that may help predict CAIX score may be of great clinical value.
AB - OBJECTIVE. The purpose of this study was to determine whether qualitative MDCT features are associated with the carbonic anhydrase IX (CAIX) score of clear cell renal cell carcinoma (RCC). The CAIX score has been previously found to have prognostic significance for disease-free survival, overall survival, and lymph node involvement. MATERIALS AND METHODS. A cohort of 105 histologically proven clear cell RCCs in patients who underwent preoperative four-phase renal mass MDCT was derived from 2001 to 2013. Two genitourinary radiologists evaluated each lesion for the gross appearance of intratumoral vascularity, calcification, enhancement pattern, necrosis, margin, collecting system invasion, and renal vein invasion. Immunohistochemical analysis was used to determine the CAIX score (defined as the positive staining percentage multiplied by the staining intensity). Logistic and linear regression analyses were performed. RESULTS. In a linear regression model controlled for lesion size and stage, the gross appearance of intratumoral vascularity had a significant positive association with CAIX score (β = 38.33, p = 0.010). In a logistic regression model controlled for lesion size and stage, the gross appearance of intratumoral vascularity had an odds ratio of 2.85 (p = 0.019) in differentiating clear cell RCCs with a CAIX score of 200–300 from clear cell RCCs with a CAIX score of 0–199. CONCLUSION. In clear cell RCCs, the gross appearance of intratumoral vascularity at MDCT was significantly associated with CAIX score, a prognostically significant molecular marker. Current assessment of CAIX score requires pathologic tissue sampling and immunohistochemical analysis. A noninvasive imaging biomarker that may help predict CAIX score may be of great clinical value.
KW - Carbonic anhydrase IX
KW - Clear cell renal cell carcinoma
KW - MDCT
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U2 - 10.2214/AJR.18.19725
DO - 10.2214/AJR.18.19725
M3 - Article
C2 - 30300009
AN - SCOPUS:85056943012
VL - 211
SP - 1254
EP - 1258
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
SN - 0361-803X
IS - 6
ER -