International Journal of General Medicine (Apr 2024)
Can We Predict the Grade of Clear Cell Renal Cell Carcinoma from Houns-Field Unit of Renal Lesion on Computerized Tomography Scan, a Retrospective Cross-Sectional Study
Abstract
Mohammad Al-Zubi,1 Khayry Al-Shami,2 Leen Sawalha,3 Heyam Mahmoud Alguzo,2 Saddam Al Demour,4 Asma’a Mohammad Al-Mnayyis,2 Rami Alazab,5 Samer Fathi Al-Rawashdah,6 Lana Talal Alzoubi,7 Sawsan Radi Al-khawaldeh2 1Department of Surgery, Division of Urology, Yarmouk University MEdical SChool, Irbid, 21110, Jodan; 2Department of Clinical Medical Sciences, Yarmouk University Medical school, Irbid, Jordan; 3Department of Clinical Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Special Surgery, Division of Urology, the University of Jordan medical School, Amman, 11972, Jordan; 5Department of Surgery & Urology, Jordan University of Science & Technology, Irbid, 21110, Jordan; 6Department of Special Surgery, School of Medicine, Mutah University medical School, Karak, 61710, Jordan; 7Department of Dentistry, Private Sector, Amman, JordanCorrespondence: Mohammad Al-Zubi, Tel +962 789724264, Email [email protected]: Renal cell carcinoma (RCC) is a type of urological malignancy that affects approximately 2% of the global population. Imaging modalities, especially computed tomography (CT) scanning, play a critical role in diagnosing RCC. In this study, we investigated whether there is a relationship between tumour grade of clear cell RCC and HU values of renal lesions on CT scan performed before operation.Materials and Methods: We conducted a retrospective analysis of 123 patients who underwent radical or partial (open or laparoscopic) nephrectomy for clear cell RCC between January 2017 and January 2021. Post-operation histopathological grades were recorded according to World Health Organization (WHO)/International Society of Urological Pathology (ISUP) 2016 grading system and divided into low grade (includes grade 1 and 2) and high grade (grade 3 and 4), and their links to age, sex, smoking habits, tumour size, and HUs of renal lesions were evaluated.Results: The mean age of the patients studied was 63.02 years old. About 56.9% of the patients were low grade (grade 1 or grade 2), while 43.1% were high grade (grade 3 or 4). The mean tumour size was 6.31 cm. There were no significant differences in tumour grade according to age, sex, or smoking habits. We found a significant relation between tumour grade and HU in the pre-contrast and nephrogenic phases, with p values of 0.001 and 0.037, respectively. On the other hand, there was no significant relation linking the tumour grade to the difference in HU between these phases, where there was a p value of 0.641.Conclusion: HU in the pre-contrast and nephrogenic phases in addition to tumour size on CT scan have a significant relation to clear cell RCC grade.Keywords: renal cell carcinoma, grade, stage, Hounsfield unit, CT scan
