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Objective <p>To investigate the correlation between preoperative magnetic resonance imaging (MRI) assessment of pseudocapsule integrity (PCI) and postoperative pathological features in clear cell renal cell carcinoma (ccRCC).</p> Methods <p>A total of 163 ccRCC patients who underwent partial or radical nephrectomy (RN) were retrospectively included in this study, with preoperative MRI performed to evaluate PCI. Clinicopathological characteristics were compared between the high- and low-PCI groups, and multivariable logistic regression was used to determine predictors of pathological features and surgical selection.</p> Results <p>Of the 163 patients, 132 (81.0%) had high PCI and 31 (19.0%) had low PCI, with favorable interobserver agreement (ICC = 0.802). The High PCI group had significantly larger tumor diameters, higher R.E.N.A.L. scores, higher proportion of RN, higher pathological T stages, and higher tumor grades and a higher rate of postoperative pathological upstaging (all <i>P</i> &lt; 0.05). On multivariable logistic regression analyses, higher PCI was an independent protective factor against high pathological T stage (OR = 0.14, 95% CI: 0.02–0.99, <i>P</i> = 0.048), renal sinus or perinephric fat invasion (OR = 0.10, 95% CI: 0.01–0.89, <i>P</i> = 0.039), and RN selection (OR = 0.15, 95% CI: 0.03–0.65, <i>P</i> = 0.012).</p> Conclusion <p>MRI-assessed PCI is significantly correlated with pathological features in ccRCC, serving as a potential tool for preoperative risk stratification. Lower PCI suggests an increased risk of adverse pathological outcomes, whereas higher PCI correlates with less aggressive tumor phenotypes and a lower likelihood of RN.</p>

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The association between preoperative pseudocapsule integrity on magnetic resonance imaging and the pathological features of clear cell renal cell carcinoma

  • 期刊论文

  • 发表日期：

    2026年7月11日

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  • Haonan Chen,
  • Chaoran Zhao,
  • Tianxiao Hong,
  • Jiawei Li,
  • Xueying Sun,
  • Xiaofei Mu,
  • Yingying Gu,
  • Pengchao Li

摘要

Objective

To investigate the correlation between preoperative magnetic resonance imaging (MRI) assessment of pseudocapsule integrity (PCI) and postoperative pathological features in clear cell renal cell carcinoma (ccRCC).

Methods

A total of 163 ccRCC patients who underwent partial or radical nephrectomy (RN) were retrospectively included in this study, with preoperative MRI performed to evaluate PCI. Clinicopathological characteristics were compared between the high- and low-PCI groups, and multivariable logistic regression was used to determine predictors of pathological features and surgical selection.

Results

Of the 163 patients, 132 (81.0%) had high PCI and 31 (19.0%) had low PCI, with favorable interobserver agreement (ICC = 0.802). The High PCI group had significantly larger tumor diameters, higher R.E.N.A.L. scores, higher proportion of RN, higher pathological T stages, and higher tumor grades and a higher rate of postoperative pathological upstaging (all P < 0.05). On multivariable logistic regression analyses, higher PCI was an independent protective factor against high pathological T stage (OR = 0.14, 95% CI: 0.02–0.99, P = 0.048), renal sinus or perinephric fat invasion (OR = 0.10, 95% CI: 0.01–0.89, P = 0.039), and RN selection (OR = 0.15, 95% CI: 0.03–0.65, P = 0.012).

Conclusion

MRI-assessed PCI is significantly correlated with pathological features in ccRCC, serving as a potential tool for preoperative risk stratification. Lower PCI suggests an increased risk of adverse pathological outcomes, whereas higher PCI correlates with less aggressive tumor phenotypes and a lower likelihood of RN.