Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Int J Urol. 2011 Jan;18(1):5-19. doi: 10.1111/j.1442-2042.2010.02641.x. Epub 2010 Oct 28.
Renal mass sampling (RMS) can be carried out by core biopsy or fine needle aspiration with each presenting potential advantages and limitations. The literature about RMS is confounded by a lack of standardized techniques, ambiguous terminology, imprecise definitions of accuracy, substantial rates of non-informative biopsies, and recurrent diagnostic challenges with respect to eosinophilic neoplasms. Despite these concerns, RMS has an expanding role in the evaluation and treatment of renal masses, in order to stratify biological aggressiveness and guide management that can range from surgery to active surveillance. Non-informative biopsies can be managed with surgical excision or repeat biopsy, with the latter showing encouraging results in recent studies. We propose a new classification in which all biopsies are categorized as non-informative versus informative, with the latter being subclassified as confirmed accurate, presumed accurate or confirmed inaccurate. This terminology will facilitate the comparison of results from various studies and stimulate progress. Incorporation of novel biomarkers and molecular fingerprinting into RMS protocols will likely allow for more rational management of patients with renal masses in the near future.
肾肿瘤取样 (RMS) 可以通过核心活检或细针抽吸进行，每种方法都有潜在的优点和局限性。关于 RMS 的文献存在缺乏标准化技术、术语含糊不清、准确性定义不精确、大量非信息性活检以及嗜酸性肿瘤的诊断挑战反复出现等问题。尽管存在这些问题，但 RMS 在评估和治疗肾肿瘤方面的作用不断扩大，以对生物学侵袭性进行分层，并指导管理，范围从手术到主动监测。非信息性活检可以通过手术切除或重复活检来处理，后者在最近的研究中显示出令人鼓舞的结果。我们提出了一种新的分类方法，其中所有的活检都分为信息性和非信息性，后者进一步分为确诊准确、推测准确或确诊不准确。这种术语将有助于比较来自不同研究的结果，并推动进展。将新型生物标志物和分子指纹图谱纳入 RMS 方案中，可能会在不久的将来为肾肿瘤患者的更合理管理提供可能。
