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[1]龙安安,王尚任 杨永姣,陈业刚,等.Bosniak分级在肾囊性病变良恶性诊断的应用价值[J].天津医科大学学报,2017,23(02):118-120.
　LONG An-an,WANG Shang-ren,YANG Yong-jiao,et al.Clinical reliability of the Bosniak classification as a diagnostic method of renal cysts[J].Journal of Tianjin Medical University,2017,23(02):118-120.
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
23卷
期数:
2017年02期
页码:
118-120
栏目:
专题报道
出版日期:
2017-03-20

文章信息/Info

Title:
Clinical reliability of the Bosniak classification as a diagnostic method of renal cysts
文章编号:
1006-8147（2017）02-0118-03
作者:
龙安安; 王尚任 杨永姣; 陈业刚; 刘晓强
（天津医科大学第二医院泌尿外科，天津市泌尿外科研究所，天津300211）
Author(s):
LONG An-an ;  WANG Shang-ren;  YANG Yong-jiao;  CHEN Ye-gang; LIU Xiao-qiang
(Department of Urology, The Second Hospital , Tianjin Medical University, Tianjin Institute of Urology,Tianjin 300211, China)
关键词:
Bosniak分级; 肾囊性病变; 肾细胞癌
Keywords:
Bosniak classification ;  renal cysts;  renal cell carcinoma
分类号:
R737.11
DOI:
-
文献标志码:
A
摘要:
目的：分析肾囊性病变的临床及病理学特点，探讨Bosniak 分级对肾囊性病变良恶性诊断的临床应用价值。方法：回顾性分析 CT或MRI诊断为肾囊性病变的239例患者的临床资料，所有患者都行手术治疗，分析在不同Bosniak分级中肾囊性病变良恶性比例，用ROC曲线确定Bosniak分级在肾囊性病变中鉴别良恶性的最佳分界点。结果：在239名肾囊性病变手术患者中，恶性病变48例（20.1%），良性病变191例（79.9%），不同Bosniak分级及恶性病变率为：Ⅰ级1.7%（2/121）、Ⅱ级4.8%（1/21）、ⅡF级9.3%（4/43）、Ⅲ级50% (11/22)、Ⅳ级93.8%（30/32）。术后病理显示：恶性病变48例（透明细胞癌41例，乳头状细胞癌4例，囊性肾癌3例），单纯肾囊肿185例，肾错构瘤3例，肾囊性肾瘤1例。ROC曲线结果显示，Bosniak Ⅲ级为判断肾囊性病变良恶性的最佳分界点，其预测肾囊性病变恶性的敏感性为86.0%，特异性为94.2%，阳性预测值为79.6%，阴性预测值为96.2%。结论：Bosniak分级对肾囊性病变良恶性的判断具有较高的临床应用价值，Bosniak分级≥Ⅲ级时，肾囊性病变恶性率较高，应积极进行手术治疗。
Abstract:
Objective: To analyze the clinical and pathologic features of cystic renal masses, and to evaluate the clinical reliability of the Bosniak classification. Methods: The clinical data of 239 patients of renal cysts diagnosed by CT or MRI scan were retrospectively reviewed. All patients were treated through operation .The benign/malignant ratio and clinical characteristics of each category were analyzed. ROC curve was applied to determine the cut-off point that identified the benign and malignancy in the renal cysts based on Bosniak classification. Results: In 239 surgically excised lesions from patients with renal cysts, the percentages of malignancy in the different Bosniak classifications were as follows: category I, 1.7% (2 of 121); II, 4.8% (1 of 21); IIF, 9.3% (4 of 43); III, 50.0% (11 of 22); and IV, 93.8% (30 of 32). Postoperative pathological examination detected malignant tumors in 48 cases (41 clear cell carcinoma,4 papillary carcinoma and 1 cystic renal cell carcinoma). A total of 191 cases were benign (185 simple cyst, 3 renal angiomyolipoma and 1 multilocular cystic nephroma). According to the ROC curve, Bosniak category Ⅲ was the cut-off point to predict malignancy of renal cysts with sensitivity of 86.0%, specificity of 94.2%, 79.6% positive predictive value, and 96.2% negative predictive value. Conclusion: The Bosniak classification system may have high clinical reliability as a diagnostic method of renal cysts, and the Bosniak category Ⅲ and Ⅳ cystic renal lesions are more likely to be malignant. Therefore, surgical operation is advised.

参考文献/References:

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备注/Memo

备注/Memo:
?作者简介? 龙安安（1991-），男，硕士在读，研究方向：泌尿外科；通信作者：刘晓强, E-mail: 13820915038@163.com。
更新日期/Last Update: 2017-03-28