单纯性肾囊肿恶变潜能的长期随访研究
Long-term follow-up study of the malignant transformation potential of the simple renal cysts.
作者信息
Yang Bicheng, Qiu Chunhua, Wan Shawpong, Liu Jianhua, Li Qingxiu, Mai Zanlin, Zeng Tao, Liu Yang, He Weizhen, Zeng Guohua
机构信息
Department of Urology, Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou 510230, China.
Department of Medical Ultrasound, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510080, China.
出版信息
Transl Androl Urol. 2020 Apr;9(2):684-689. doi: 10.21037/tau.2020.03.29.
BACKGROUND
We conducted a multi-center study to investigate the prevalence, the malignant transformation potential of the simple renal cysts and the factors that might predict malignancy.
METHODS
We defined the simple renal cysts as Bosniak class I & II (including IIF) lesions. In the prevalence study, data from 115,132 ultrasonographies was collected from individuals who participated in a multiphasic health wellness screen. In the natural history and progression study, we retrospectively reviewed 333 participants with simple renal cysts and were followed for at the least 3 years with a mean of 6.3±2.9 years (ranged from 3 to 13 years).
RESULTS
About 7.2% (8,303) of the individuals who participated in the study were found to have at the least one simple renal cyst. The incidence increased with age from 0.6% in the first decade to 28.0% in the eighth or later decade of life. The Bosniak class I lesion accounted for 7,559 or 91.0% of the cysts whereas 744 or 9.0% were class II. A slower growth rate was observed in the older age group. Twenty-four patients (7.2%) had their renal cysts upgraded according to the Bosniak classification. Gender, age, initial cyst size, number of cysts and bi-laterality failed to predict the malignancy tendency.
CONCLUSIONS
Most of the cysts discovered were the Bosniak class I and II lesions and they rarely progress further. Treatment for the asymptomatic simple renal cyst is not warranted. Treatment decision-making based on older age or larger initial cyst size should not be recommended.
背景
我们开展了一项多中心研究，以调查单纯性肾囊肿的患病率、恶变潜能以及可能预测恶变的因素。
方法
我们将单纯性肾囊肿定义为博斯尼亚克I级和II级（包括IIF级）病变。在患病率研究中，收集了参与多阶段健康体检的个体的115132份超声检查数据。在自然病史和进展研究中，我们回顾性分析了333例单纯性肾囊肿患者，随访至少3年，平均随访时间为6.3±2.9年（范围为3至13年）。
结果
参与研究的个体中，约7.2%（8303例）被发现至少有一个单纯性肾囊肿。发病率随年龄增长而增加，从第一个十年的0.6%增至第八个十年及以后的28.0%。博斯尼亚克I级病变占囊肿的7559个（91.0%），而II级病变占744个（9.0%）。老年组观察到囊肿生长速度较慢。24例患者（7.2%）的肾囊肿根据博斯尼亚克分类进行了升级。性别、年龄、初始囊肿大小、囊肿数量和双侧性均不能预测恶变倾向。
结论
发现的大多数囊肿为博斯尼亚克I级和II级病变，很少进一步进展。无症状的单纯性肾囊肿无需治疗。不建议基于年龄较大或初始囊肿较大来进行治疗决策。
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