10022-met-2 肾细胞癌脑转移的临床特征与其他癌症的比较

Yohei Yamamoto, Toshihide Tanaka, Jun Takei, A. Teshigawara, Shohei Nawate, Kyoichi Tomoto, Takuya Ishi, Y. Hasegawa, Y. Akasaki, Yuichi Murayama
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摘要

近年来,转移性脑肿瘤的手术治疗定位发生了变化。为了找出适合手术治疗的条件,我们通过对病例的回顾性分析来验证每个原发病变的背景因素。研究对象和方法纳入2014年至2022年在我校诊断和治疗的425例转移性脑肿瘤患者。其中肺癌219例,乳腺癌46例,胃肠道癌64例,肾细胞癌26例,其他70例。首先测量肿瘤体积和水肿体积,并绘制有无症状的ROC曲线,确定截断值。之后,对每个原发病变进行如下统计分析。项目为肿瘤体积(T)、水肿体积(E)、肿瘤水肿比(E/T)、年龄、KPS、出血、囊肿形成、脑膜炎、其他器官转移、后窝、同时检测、单个肿瘤。结果肿瘤体积为1514mm3(敏感性0.86,特异性0.74),水肿体积为15616mm3(敏感性0.85,特异性0.85)。肾细胞癌的水肿率明显高于肾细胞癌。差异有统计学意义的因素为肺癌年龄较大、多发病变、乳腺癌年龄较小、后窝、胃肠道癌KPS较低、肾癌单发、出血。讨论/结论在本分析中,许多肾细胞癌脑转移病例是孤立的,由于其表现为广泛的水肿,似乎受VEGF的影响,因此它们往往在很小的时候就出现症状,并且在过程中容易出血。这些发现提示肾细胞癌脑转移患者应优先考虑手术治疗。
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10022-MET-2 CLINICAL FEATURES OF RENAL CELL CARCINOMA BRAIN METASTASES COMPARED WITH OTHER CARCINOMAS
Abstract INTRODUCTION In recent years, the positioning of surgical treatment for metastatic brain tumors has changed. To extract conditions suitable for surgical treatment, the background factors for each primary lesion were verified by retrospective analysis of our case. SUBJECTS AND METHODS From 2014 to 2022, 425 patients with metastatic brain tumors diagnosed and treated at our university were included. There were 219 lung cancers, 46 breast cancers, 64 gastrointestinal cancers, 26 renal cell carcinomas, and 70 others. First, the tumor volume and edema volume were measured, and the ROC curve was drawn for the presence or absence of symptoms to determine the cutoff value. After that, statistical analysis was performed on the following items for each primary lesion. The items were tumor volume (T), edema volume (E), tumor edema ratio (E/T), age, KPS, hemorrhage, cyst formation, meningitis, metastasis to other organs, posterior fossa, simultaneous detection, and single tumor. RESULTS The symptomatic cutoff was 1514mm3 for tumor volume (sensitivity 0.86 specificity 0.74) and 15616 mm3 for edema volume (sensitivity 0.85 specificity 0.85). The tumor edema ratio was significantly higher in renal cell carcinoma. Factors with significant differences were older age and multiple lesions in lung cancer, younger age and posterior fossa in breast cancer, lower KPS in gastrointestinal cancer, and solitary cases and bleeding in renal cell carcinoma. DISCUSSION/CONCLUSION In this analysis, many cases of brain metastasis from renal cell carcinoma are solitary, and because they exhibit extensive edema that seems to be affected by VEGF, they tend to develop symptoms while they are small, and they are characterized by hemorrhage easily during the course. These findings suggest that patients with brain metastases from renal cell carcinoma should be given priority for surgical treatment.
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