多学科团队会议明确了复杂肾囊肿的 Bosniak 分类。
Multi-disciplinary team conference clarifies bosniak classification of complex renal cysts.
机构信息
Department of Urology, Zealand University Hospital, Roskilde, Denmark.
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
出版信息
Scand J Urol. 2021 Feb;55(1):78-82. doi: 10.1080/21681805.2020.1857830. Epub 2020 Dec 12.
OBJECTIVES
The aims of this study are to determine the progression rate of Bosniak IIF cysts, the malignancy rates of complex renal cysts in patients undergoing surgery and explore the influence of multi-disciplinary team conference (MDT) on re-classification of Bosniak cysts.
MATERIALS AND METHODS
All CT scans from January 2010 to 2017 were pooled into a database. Initially, 167 patients were identified with possible Bosniak IIF, III or IV cysts. Patients with follow up of less than 24 months, without progression or regression were excluded.
RESULTS
Thirty-one (18.6%) cysts of the initial 167 cysts were either up or downgraded at a MDT. Twenty-six of the 31 cysts were up or downgraded at the primary MDT, 13 cysts (50%) were downgraded, five cysts (19.2%) were upgraded and eight cysts (30.8%) were re-classified as solid tumors. Of those 19/26 (73.1%) were primary interpreted by a periphery radiologist and re-classified centrally. The last five patients 5/120 cysts (4.2%) were re-classified during follow up. 116 patients with a total of 120 cysts met the inclusion criteria, 79 (65.8%) Bosniak IIF, 28 (23.3%) Bosniak III and 13 (10.8%) Bosniak IV cysts represented. Median follow up of Bosniak IIF cysts were 46 months. One Bosniak IIF cyst progressed to a solid tumor at 15 months from diagnosis, progression rate 1.3%. Histopathology was papillary renal cell carcinoma. Malignancy rates of Bosniak III and IV cysts were 50% and 78%, respectively.
CONCLUSION
Multi-disciplinary team conference may have an important role in correct classification of Bosniak cysts.
TRIAL REGISTRATION
None.
目的
本研究旨在确定 Bosniak IIF 囊肿的进展速度、手术患者中复杂肾囊肿的恶性率，并探讨多学科团队会议（MDT）对 Bosniak 囊肿再分类的影响。
材料和方法
将 2010 年 1 月至 2017 年的所有 CT 扫描结果汇总到一个数据库中。最初，确定了 167 例可能为 Bosniak IIF、III 或 IV 囊肿的患者。排除随访时间少于 24 个月、无进展或消退的患者。
结果
在 MDT 中，167 例初始囊肿中有 31 例（18.6%）囊肿分级升高或降低。26 例囊肿在原发性 MDT 中升高或降低，其中 13 例（50%）降低，5 例（19.2%）升高，8 例（30.8%）重新分类为实体肿瘤。其中 19/26（73.1%）例由外周放射科医生初次解读，由中心重新分类。最后 5 例（5/120 例，4.2%）在随访期间重新分类。符合纳入标准的患者共 116 例，总计 120 例囊肿，其中 79 例（65.8%）为 Bosniak IIF 囊肿，28 例（23.3%）为 Bosniak III 囊肿，13 例（10.8%）为 Bosniak IV 囊肿。Bosniak IIF 囊肿的中位随访时间为 46 个月。1 例 Bosniak IIF 囊肿在诊断后 15 个月进展为实性肿瘤，进展率为 1.3%。组织病理学为乳头状肾细胞癌。Bosniak III 和 IV 囊肿的恶性率分别为 50%和 78%。
结论
多学科团队会议可能在 Bosniak 囊肿的正确分类中发挥重要作用。
试验注册
无。
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