Departments of Radiology, Mayo Clinic, Rochester, MN 55902, USA.
BJU Int. 2012 Nov;110(10):1444-8. doi: 10.1111/j.1464-410X.2012.011136.x. Epub 2012 Apr 23.
To describe the growth rates of oncocytomas before treatment with surgical resection or percutaneous ablation.
This single-institution retrospective study included 33 consecutive, pathologically proven renal oncocytomas with serial contrast-enhanced computed tomography scans spanning at least 1 year before intervention, from 2000 to 2009. Tumours were measured by two radiologists, and growth rates and interobserver variability were calculated. The mean (range) pre-procedural imaging surveillance period was 36 (12-124) months (median 33 months).
The mean (SD) oncocytoma size was 17 (11) mm (range 4-47 mm, median 15 mm) in maximum transverse diameter on initial imaging and grew to a mean (SD) of 26 (5) mm (range 10-83 mm, median 23 mm) by the time of treatment. Overall, the mean (SD) and median growth rates were 2.9 (2.6) mm/year and 2.7 mm/year, respectively (range -1.2-10.9 mm/year). After weighting by the se of each tumour's growth rate, the mean (SD) change was 2.1 (1.2) mm/year. The mean (range) interobserver variability for each tumour measurement was 1 (0-7) mm with an intraclass correlation coefficient of 0.99.
Renal oncocytomas grow at a rate similar to reported growth rates of renal cell carcinoma. As the observation of growth does not distinguish between benign and malignant renal tumours, growth of small renal masses under active surveillance should be carefully considered before a switch is made to intervention.
描述经手术切除或经皮消融治疗前肾嗜酸细胞瘤的生长速度。
这是一项单中心回顾性研究,纳入了 2000 年至 2009 年间连续的 33 例经病理证实的肾嗜酸细胞瘤患者,这些患者均至少有 1 年的连续增强 CT 扫描资料,可用于评估肿瘤的生长情况。由两名放射科医生对肿瘤进行测量,计算生长速度和观察者间的差异。术前影像学监测时间的平均(范围)为 36(12-124)个月(中位数 33 个月)。
初始影像学上最大横径的平均(标准差)肿瘤大小为 17(11)mm(范围 4-47mm,中位数 15mm),治疗时平均(标准差)增长至 26(5)mm(范围 10-83mm,中位数 23mm)。总的来说,平均(标准差)和中位数生长速度分别为 2.9(2.6)mm/年和 2.7mm/年(范围-1.2-10.9mm/年)。经肿瘤生长速度加权后,平均(标准差)变化为 2.1(1.2)mm/年。每个肿瘤测量的观察者间差异的平均(范围)为 1(0-7)mm,组内相关系数为 0.99。
肾嗜酸细胞瘤的生长速度与肾细胞癌的报告生长速度相似。由于观察到的生长并不能区分良性和恶性肾肿瘤,因此在考虑将主动监测的小肾肿块转为干预之前,应仔细考虑。