Baio Raffaele, Molisso Giovanni, Caruana Christian, Di Mauro Umberto, Intilla Olivier, Pane Umberto, D'Angelo Costantino, Campitelli Antonio, Pentimalli Francesca, Sanseverino Roberto
Department of Medicine and Surgery "Scuola Medica Salernitana", University of Salerno, 84081 Salerno, Italy.
Department of Urology, Umberto I, Nocera Inferiore, 84014 Salerno, Italy.
Bioengineering (Basel). 2023 Jul 3;10(7):794. doi: 10.3390/bioengineering10070794.
Due to the increased use of common and non-invasive abdominal imaging techniques over the last few decades, the diagnosis of about 60% of renal tumors is incidental. Contrast-enhancing renal nodules on computed tomography are diagnosed as malignant tumors, which are often removed surgically without first performing a biopsy. Most kidney nodules are renal cell carcinoma (RCC) after surgical treatment, but a non-negligible rate of these nodules may be benign on final pathology; as a result, patients undergo unnecessary surgery with an associated significant morbidity. Our study aimed to identify a subgroup of patients with higher odds of harboring benign tumors, who would hence benefit from further diagnostic examinations (such as renal biopsy) or active surveillance. We performed a retrospective review of the medical data, including pathology results, of patients undergoing surgery for solid renal masses that were suspected to be RCCs (for a total sample of 307 patients). Owing to the widespread use of common and non-invasive imaging techniques, the incidental diagnosis of kidney tumors has become increasingly common. Considering that a non-negligible rate of these tumors is found to be benign after surgery at pathological examination, it is crucial to identify features that can correctly diagnose a mass as benign or not. According to our study results, female sex and tumor size ≤ 3 cm were independent predictors of benign disease. Contrary to that demonstrated by other authors, increasing patient age was also positively linked to a greater risk of malign pathology.
在过去几十年中,由于普通和非侵入性腹部成像技术的使用增加,约60%的肾肿瘤是偶然发现的。计算机断层扫描上有对比增强的肾结节被诊断为恶性肿瘤,通常在未先进行活检的情况下就进行手术切除。大多数肾结节在手术治疗后为肾细胞癌(RCC),但这些结节在最终病理检查中可能有不可忽视的比例为良性;因此,患者接受了不必要的手术,并伴有明显的发病率。我们的研究旨在确定一组患良性肿瘤几率较高的患者,这些患者将因此受益于进一步的诊断检查(如肾活检)或主动监测。我们对疑似为RCC的实性肾肿块手术患者的医疗数据(包括病理结果)进行了回顾性研究(共307例患者样本)。由于普通和非侵入性成像技术的广泛应用,肾肿瘤的偶然诊断越来越普遍。鉴于这些肿瘤在手术后病理检查中发现有不可忽视的比例为良性,识别能够正确诊断肿块是否为良性的特征至关重要。根据我们的研究结果,女性和肿瘤大小≤3 cm是良性疾病的独立预测因素。与其他作者的研究结果相反,患者年龄增加也与恶性病理风险增加呈正相关。