Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL 33612-9416, USA.
Urology. 2011 Sep;78(3):592-4. doi: 10.1016/j.urology.2011.05.023. Epub 2011 Jul 22.
To determine the reliability of the RENAL nephrometry scoring system by studying its reproducibility among different observers.
We reviewed computed tomography or magnetic resonance imaging scans from 51 patients who underwent partial nephrectomy at our cancer center. Digitized axial and coronal images were available for all patients. Three surgeons independently scored the renal tumors using the RENAL nephrometry system. The scoring system had 5 components: R (tumor diameter), E (exophytic/endophytic), N (nearness to collecting system), A (anterior/posterior), and L (location in relation to polar lines). Interobserver variability was calculated for each of the 5 components using a frequency procedure and Kappa statistics.
The reliability assessed by frequency procedure showed concordance among 3 observers in 94%, 76%, 66%, 80%, and 54% for the R, E, N, A, and L components, respectively. The corresponding kappa values for each of these 5 components were 0.95, 0.86, 0.76, 0.84, and 0.73, respectively.
The RENAL nephrometry scoring system has good interobserver reliability. Quantifying the tumor location (L) was more challenging and the least reliable of the 5 components. This variation might affect the total nephrometry score and should be considered when using the system to compare different series of patients undergoing partial nephrectomy.
通过研究不同观察者之间的可重复性，确定 RENAL 肾脏分段评分系统的可靠性。
我们回顾了在我们癌症中心接受部分肾切除术的 51 名患者的计算机断层扫描或磁共振成像扫描。所有患者均提供了数字化的轴向和冠状图像。三位外科医生使用 RENAL 肾脏分段评分系统独立对肾脏肿瘤进行评分。该评分系统有 5 个组成部分：R（肿瘤直径）、E（外生性/内生性）、N（靠近收集系统）、A（前/后）和 L（相对于极线的位置）。使用频率程序和 Kappa 统计计算每个 5 个组成部分的观察者间变异性。
频率程序评估的可靠性显示，3 位观察者在 R、E、N、A 和 L 成分方面的一致性分别为 94%、76%、66%、80%和 54%。这些 5 个组成部分的相应 Kappa 值分别为 0.95、0.86、0.76、0.84 和 0.73。
RENAL 肾脏分段评分系统具有良好的观察者间可靠性。定量评估肿瘤位置（L）更具挑战性，也是 5 个组成部分中最不可靠的。这种差异可能会影响总的肾脏分段评分，在使用该系统比较接受部分肾切除术的不同患者系列时应予以考虑。
