Department of Urology, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands.
J Endourol. 2012 Jun;26(6):737-47. doi: 10.1089/end.2011.0407. Epub 2012 Feb 10.
The vast increase in recent publications on renal mass biopsy (RMB) suggests an increased interest in the subject. The objective of the survey was to assess the use of RMB in current urologic practice, including related factors such as indications and patterns in practice.
The link to a web-based questionnaire ( www.surveymonkey.com ) was sent to all registered e-mail addresses (1854) of members of the Endourological Society in December 2010. The questionnaire contained six epidemiologic questions, 10 regarding patterns of practice, one regarding the influence of the literature, and one on future techniques. Chi-square test (for trends) was used to assess statistical significant differences among categorical answers.
In total, 190 responders completed the survey of whom 73% indicated performing RMB "never" or "rarely" compared with 9% performing RMB in 25% to 100% of cases. Thirteen percent of responders reported never to take a RMB. Of the latter, significantly fewer practice in university hospitals (6% vs 20%-30%, P=0.003). Main indications to perform RMB are still tumors in solitary/transplant kidneys and in metastatic disease. Lack of influence on clinical management and risk of false negatives were the main reasons not to perform biopsies. Sixty-one percent prefer histological biopsies compared with 8% who prefer cytological aspiration; 31% indicated that they combine both techniques. Other tissue differentiation techniques (Optical Coherence Tomography, Raman-spectroscopy) are unknown to 65% of urologists.
RMB is not yet applied widely in urologic practice, with academic urologists performing RMB less infrequently. Core biopsies are still preferred, although combined with cytologic punctures by a considerable number of responders.
最近有关肾肿瘤活组织检查（RMB）的文献大量增加，表明人们对此领域的兴趣日益增加。本调查的目的是评估 RMB 在当前泌尿外科实践中的应用，包括相关因素，如适应证和实践模式。
2010 年 12 月，向欧洲泌尿外科学会的所有注册电子邮件地址（1854 个）发送了一个网络调查问卷的链接（www.surveymonkey.com）。问卷包含 6 个流行病学问题、10 个关于实践模式的问题、1 个关于文献影响的问题和 1 个关于未来技术的问题。使用卡方检验（趋势）评估分类回答之间的统计学差异。
共有 190 名应答者完成了调查，其中 73%的人表示“从未”或“很少”进行 RMB，而 9%的人在 25%至 100%的病例中进行 RMB。13%的应答者报告从未进行过 RMB。其中，在大学医院工作的人数明显较少（6%比 20%-30%，P=0.003）。进行 RMB 的主要适应证仍然是孤立/移植肾肿瘤和转移性疾病。不进行活检的主要原因是对临床管理没有影响和存在假阴性的风险。61%的人更喜欢组织学活检，而 8%的人更喜欢细胞学抽吸；31%的人表示他们结合了这两种技术。65%的泌尿科医生不知道其他组织鉴别技术（光学相干断层扫描、拉曼光谱）。
RMB 在泌尿外科实践中尚未广泛应用，学术泌尿科医生进行 RMB 的频率较低。核心活检仍然是首选，但相当多的应答者还结合了细胞学穿刺。
