Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Izmir, Turkey.
Urology. 2019 Jul;129:126-131. doi: 10.1016/j.urology.2019.04.016. Epub 2019 Apr 19.
To evaluate the histopathologic correlation of recently described subclassification of Bosniak category 3 cysts (3s and 3n).
A total of 106 patients who underwent partial/radical nephrectomy due to a complex renal cyst (≥Bosniak 3) were retrospectively reviewed. All the scans of the patients were reevaluated by 2 experienced uroradiologists. Bosniak 3 cysts were reclassified as 3n (nodularity on the cyst wall/septae) and 3s (septated cysts without nodularity) as described in a recently published paper. Group 1 consisted of patients with Bosniak 3s, Group 2 consisted of patients with Bosniak 3n, and Group 3 consisted of patients with Bosniak 4 cysts. Three groups were compared according to patients' characteristics, radiological findings, histopathologic results, and survival outcomes.
There were 52 patients in Bosniak 3 group and 54 patients in Bosniak 4 group. Mean follow-up was 35.3 months. Among Bosniak 3 cysts, 37 lesions were classified in 3s and 15 were classified in 3n. Malignancy was higher in 3n group than 3s (86.7% vs 54.1%, P= .026). Lesion size was significantly lower for malignant cysts compared to benign ones in the patients with Bosniak 3 lesions (44.2 ± 27.5 vs 80 ± 55.9 P= .005). In the subgroups, malignant lesions were significantly smaller than benign lesions in 3s group similar to general Bosniak 3 group. Most of the Bosniak 3 lesions were organ confined and low grade.
The subclassification of Bosniak 3 cysts as 3s and 3n can help to differentiate highly suspicious malignant lesions from the relatively less suspicious ones.
评估最近描述的 Bosniak 3 类囊肿（3s 和 3n）细分的组织病理学相关性。
回顾性分析了 106 例因复杂肾囊肿（≥Bosniak 3）而行部分/根治性肾切除术的患者。由 2 名有经验的泌尿放射科医生对所有患者的扫描结果进行重新评估。Bosniak 3 类囊肿根据最近发表的一篇论文中的描述，重新分类为 3n（囊肿壁/间隔结节）和 3s（无结节的分隔囊肿）。第 1 组包括 Bosniak 3s 患者，第 2 组包括 Bosniak 3n 患者，第 3 组包括 Bosniak 4 类囊肿患者。根据患者特征、影像学表现、组织病理学结果和生存结果比较三组患者。
Bosniak 3 组有 52 例患者，Bosniak 4 组有 54 例患者。平均随访时间为 35.3 个月。在 Bosniak 3 类囊肿中，37 个病变被分类为 3s，15 个病变被分类为 3n。3n 组的恶性肿瘤发生率高于 3s 组（86.7% vs 54.1%，P=.026）。Bosniak 3 类病变患者中，恶性囊肿的病变大小明显小于良性囊肿（44.2±27.5 vs 80±55.9，P=.005）。在亚组中，3s 组的恶性病变明显小于良性病变，与一般 Bosniak 3 组相似。大多数 Bosniak 3 类病变为器官局限且低度恶性。
Bosniak 3 类囊肿的细分，即 3s 和 3n，可以帮助区分高度可疑的恶性病变和相对不太可疑的病变。
