Huang Haiwen, Song Haifeng, Ding Tianfu, Xu YangYang, Fan Yunfei, Su Boxing, Liu Yubao, Hu Weiguo, Xiao Bo, Li Jianxing
Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
Front Med (Lausanne). 2025 May 8;12:1557702. doi: 10.3389/fmed.2025.1557702. eCollection 2025.
The existing scoring systems for percutaneous nephrolithotomy fail to adequately consider the influence of renal anatomy, leading to limited predictive accuracy. This study introduces and validates a novel B.T.C.H. nephrolithometry score, designed to better predict stone-free rates and complexity for ultrasound-guided percutaneous nephrolithotomy.
B.T.C.H. nephrolithometry score evaluates four variables including stone burden, type of renal pelvis, calyces involved, and hydronephrosis. 134 patients who underwent ultrasound-guided percutaneous nephrolithotomy at Beijing Tsinghua Changgung Hospital were retrospectively analyzed. The inter-observer agreement was assessed using the linearly weighted kappa coefficient. The accuracy in predicting the stone-free rate was evaluated using receiver operating characteristic curve analysis. Spearman's correlation analysis and Kendall's W test were employed to examine the correlation between the scores of each scoring system and operative time, the number of tracts and CDC scores.
The overall stone-free rate was 52.99%. The stone-free rates in low (4-8 points), medium (9-12 points), and high (13-15 points) B.T.C.H. scores were 91.9, 24.6, and 0%, respectively. The B.T.C.H. nephrolithometry score had an AUC of 0.909 for predicting stone-free rate, outperforming both the GSS (AUC = 0.761) and the S.T.O.N.E. nephrolithometry score (AUC = 0.763). The B.T.C.H. nephrolithometry score were positively correlated with operative time, the number of tracts and CDC scores.
B.T.C.H. nephrolithometry score is a suggested novel scoring system for ultrasound-guided percutaneous nephrolithotomy, which had superior prediction of stone-free rate and positive correlation with operative time, the number of tracts, and postoperative CDC scores.
现有的经皮肾镜取石术评分系统未能充分考虑肾脏解剖结构的影响，导致预测准确性有限。本研究引入并验证了一种新型的B.T.C.H.肾石测量评分系统，旨在更好地预测超声引导下经皮肾镜取石术的无石率和复杂性。
B.T.C.H.肾石测量评分系统评估四个变量，包括结石负荷、肾盂类型、受累肾盏和肾积水情况。对在北京清华长庚医院接受超声引导下经皮肾镜取石术的134例患者进行回顾性分析。使用线性加权kappa系数评估观察者间的一致性。采用受试者工作特征曲线分析评估预测无石率的准确性。采用Spearman相关分析和Kendall's W检验来检验各评分系统的得分与手术时间、通道数量和复杂性评分（CDC）之间的相关性。
总体无石率为52.99%。B.T.C.H.评分低（4 - 8分）、中（9 - 12分）、高（13 - 15分）组的无石率分别为91.9%、24.6%和0%。B.T.C.H.肾石测量评分系统预测无石率的曲线下面积（AUC）为0.909，优于GSS评分系统（AUC = 0.761）和S.T.O.N.E.肾石测量评分系统（AUC = 0.763）。B.T.C.H.肾石测量评分与手术时间、通道数量和复杂性评分呈正相关。
B.T.C.H.肾石测量评分系统是一种建议用于超声引导下经皮肾镜取石术的新型评分系统，对无石率具有较好的预测能力，且与手术时间、通道数量及术后复杂性评分呈正相关。
