HIỆU NĂNG CHẨN ĐOÁN GIAI ĐOẠN T BẰNG CLVT TRONG UTNM ĐƯỜNG TIẾT NIỆU TRÊN: SO SÁNH VỚI TIÊU CHUẨN MÔ BỆNH HỌC

Abstract

Background: Accurate preoperative T staging of upper tract urothelial carcinoma (UTUC) is crucial for treatment planning and prognostic assessment. While computed tomography (CT) is the most commonly used imaging modality, its diagnostic accuracy compared to histopathology remains a subject of clinical concern. Objective: To compare the diagnostic accuracy of CT with histopathological findings in determining the T stage of UTUC. Methods: A retrospective descriptive study was conducted on 63 patients with UTUC who underwent surgery at Binh Dan Hospital between 2020 and 2022. All patients received preoperative contrast-enhanced CT and had postoperative histopathological reports. Sensitivity, specificity, predictive values, and kappa statistics were used to evaluate the agreement between CT and pathology. Results: For renal pelvic tumors, CT showed a sensitivity of 73.7%, specificity of 100%, accuracy of 90.4%, and a kappa value of 0.78. For ureteral tumors, the sensitivity was 90.7%, specificity 75%, accuracy 87.3%, and kappa value 0.64. These results indicate a good agreement between CT and histopathological T staging. Conclusion: CT is a reliable imaging modality for preoperative T staging of UTUC and can effectively assist in surgical decision-making. However, limitations remain, particularly in detecting early renal pelvic invasion.