Abstract：
OBJECTIVE: Determine the proportion of malignancy within Bosniak v2019 classes.
METHODS: MEDLINE and EMBASE were searched. Eligible studies contained patients with cystic renal masses undergoing CT or MRI renal protocol examinations with pathology confirmation, applying Bosniak v2019. Proportion of malignancy was estimated within Bosniak v2019 class. Risk of bias was assessed using QUADAS-2.
RESULTS: We included 471 patients with 480 cystic renal masses. No class I malignant masses were observed. Pooled proportion of malignancy were class II, 12% (6/51, 95% CI 5-24%); class IIF, 46% (37/85, 95% CI 28-66%); class III, 79% (138/173, 95% CI 68-88%); and class IV, 84% (114/135, 95% CI 77-90%). Proportion of malignancy differed between Bosniak v2019 II-IV classes (p = 0.004). Four studies reported the proportion of malignancy by wall/septa feature. The pooled proportion of malignancy with 95% CI were class III thick smooth wall/septa, 77% (41/56, 95% CI 53-91%); class III obtuse protrusion ≤ 3 mm (irregularity), 83% (97/117, 95% CI 75-89%); and class IV nodule with acute angulation, 86% (50/58, 95% CI 75-93%) or obtuse angulation ≥ 4 mm, 83%, (64/77, 95% CI 73-90%). Subgroup analysis by wall/septa feature was limited by sample size; however, no differences were found comparing class III masses with irregularity to class IV masses (p = 0.74) or between class IV masses by acute versus obtuse angles (p = 0.62).
CONCLUSIONS: Preliminary data suggest Bosniak v2019 class IIF masses have higher proportion of malignancy compared to the original classification, controlling for pathologic reference standard. There are no differences in proportion of malignancy comparing class III masses with irregularities to class IV masses with acute or obtuse nodules.
CONCLUSIONS: • The proportion of malignancy in Bosniak v2019 class IIF cystic masses is 46% (37 malignant/85 total IIF masses, 95% confidence intervals (CI) 28-66%). • The proportion of malignancy in Bosniak v2019 class III cystic masses is 79% (138/173, 95% CI 68-88%) and in Bosniak v2019 class IV cystic masses is 84% (114/135, 95% CI 77-90%). • Class III cystic masses with irregularities had similar proportion of malignancy (83%, 97/117, 95% CI 75-89%) compared to Bosniak class IV masses (84%, 114/135, 95% CI 77-90%) overall (p = 0.74) with no difference within class IV masses by acute versus obtuse angulation (p = 0.62).
METHODS: MEDLINE and EMBASE were searched. Eligible studies contained patients with cystic renal masses undergoing CT or MRI renal protocol examinations with pathology confirmation, applying Bosniak v2019. Proportion of malignancy was estimated within Bosniak v2019 class. Risk of bias was assessed using QUADAS-2.
RESULTS: We included 471 patients with 480 cystic renal masses. No class I malignant masses were observed. Pooled proportion of malignancy were class II, 12% (6/51, 95% CI 5-24%); class IIF, 46% (37/85, 95% CI 28-66%); class III, 79% (138/173, 95% CI 68-88%); and class IV, 84% (114/135, 95% CI 77-90%). Proportion of malignancy differed between Bosniak v2019 II-IV classes (p = 0.004). Four studies reported the proportion of malignancy by wall/septa feature. The pooled proportion of malignancy with 95% CI were class III thick smooth wall/septa, 77% (41/56, 95% CI 53-91%); class III obtuse protrusion ≤ 3 mm (irregularity), 83% (97/117, 95% CI 75-89%); and class IV nodule with acute angulation, 86% (50/58, 95% CI 75-93%) or obtuse angulation ≥ 4 mm, 83%, (64/77, 95% CI 73-90%). Subgroup analysis by wall/septa feature was limited by sample size; however, no differences were found comparing class III masses with irregularity to class IV masses (p = 0.74) or between class IV masses by acute versus obtuse angles (p = 0.62).
CONCLUSIONS: Preliminary data suggest Bosniak v2019 class IIF masses have higher proportion of malignancy compared to the original classification, controlling for pathologic reference standard. There are no differences in proportion of malignancy comparing class III masses with irregularities to class IV masses with acute or obtuse nodules.
CONCLUSIONS: • The proportion of malignancy in Bosniak v2019 class IIF cystic masses is 46% (37 malignant/85 total IIF masses, 95% confidence intervals (CI) 28-66%). • The proportion of malignancy in Bosniak v2019 class III cystic masses is 79% (138/173, 95% CI 68-88%) and in Bosniak v2019 class IV cystic masses is 84% (114/135, 95% CI 77-90%). • Class III cystic masses with irregularities had similar proportion of malignancy (83%, 97/117, 95% CI 75-89%) compared to Bosniak class IV masses (84%, 114/135, 95% CI 77-90%) overall (p = 0.74) with no difference within class IV masses by acute versus obtuse angulation (p = 0.62).
摘要：
目的：确定Bosniakv2019类别中恶性肿瘤的比例。
方法：搜索MEDLINE和EMBASE。符合条件的研究包括接受CT或MRI肾脏方案检查并经病理证实的囊性肾肿块患者。应用Bosniakv2019。在Bosniakv2019类中估计恶性肿瘤的比例。使用QUADAS-2评估偏倚风险。
结果：我们纳入了471例患者，包括480个囊性肾肿块。未观察到I类恶性肿块。合并的恶性肿瘤比例为II类，12%（6/51，95%CI5-24%）；IIF类，46%（37/85，95%CI28-66%）；III类，79%（138/173，95%CI68-88%）；IV类，84%（114/135，95%CI77-90%）。Bosniakv2019II-IV类之间的恶性肿瘤比例不同（p=0.004）。四项研究报告了根据壁/间隔特征的恶性肿瘤比例。95%CI的恶性肿瘤合并比例为III级厚光滑壁/隔片，77%（41/56，95%CI53-91%）；III类钝角突出≤3mm（不规则），83％（97/117，95％CI75-89％）；IV级结节伴急性成角，86%(50/58,95%CI75-93%)或钝角≥4mm,83%,（64/77，95%CI73-90%）。按壁/间隔特征进行的亚组分析受样本大小的限制；然而，通过锐角和钝角(p=0.62)比较具有不规则性的III类肿块与IV类肿块(p=0.74)或IV类肿块之间没有差异.
结论：初步数据表明，与原始分类相比，Bosniakv2019级IIF肿块的恶性肿瘤比例更高，控制病理参考标准。与不规则的III类肿块相比，急性或钝性结节的IV类肿块的恶性比例没有差异。
结论：•Bosniakv2019级IIF囊性肿块的恶性肿瘤比例为46％（37个恶性/85个总IIF肿块，95%置信区间（CI）28-66%）。•Bosniakv2019III类囊性肿块的恶性肿瘤比例为79％（138/173，95％CI68-88％），而Bosniakv2019IV类囊性肿块的恶性肿瘤比例为84％（114/135，95％CI77-90％）。•III类囊性肿块与不规则有相似的恶性肿瘤比例（83%，97/117，95%CI75-89%）与波斯尼亚IV类质量（84%，114/135，95％CI77-90％）总体（p=0.74），在急性和钝角的IV级肿块内没有差异（p=0.62）。
方法：搜索MEDLINE和EMBASE。符合条件的研究包括接受CT或MRI肾脏方案检查并经病理证实的囊性肾肿块患者。应用Bosniakv2019。在Bosniakv2019类中估计恶性肿瘤的比例。使用QUADAS-2评估偏倚风险。
结果：我们纳入了471例患者，包括480个囊性肾肿块。未观察到I类恶性肿块。合并的恶性肿瘤比例为II类，12%（6/51，95%CI5-24%）；IIF类，46%（37/85，95%CI28-66%）；III类，79%（138/173，95%CI68-88%）；IV类，84%（114/135，95%CI77-90%）。Bosniakv2019II-IV类之间的恶性肿瘤比例不同（p=0.004）。四项研究报告了根据壁/间隔特征的恶性肿瘤比例。95%CI的恶性肿瘤合并比例为III级厚光滑壁/隔片，77%（41/56，95%CI53-91%）；III类钝角突出≤3mm（不规则），83％（97/117，95％CI75-89％）；IV级结节伴急性成角，86%(50/58,95%CI75-93%)或钝角≥4mm,83%,（64/77，95%CI73-90%）。按壁/间隔特征进行的亚组分析受样本大小的限制；然而，通过锐角和钝角(p=0.62)比较具有不规则性的III类肿块与IV类肿块(p=0.74)或IV类肿块之间没有差异.
结论：初步数据表明，与原始分类相比，Bosniakv2019级IIF肿块的恶性肿瘤比例更高，控制病理参考标准。与不规则的III类肿块相比，急性或钝性结节的IV类肿块的恶性比例没有差异。
结论：•Bosniakv2019级IIF囊性肿块的恶性肿瘤比例为46％（37个恶性/85个总IIF肿块，95%置信区间（CI）28-66%）。•Bosniakv2019III类囊性肿块的恶性肿瘤比例为79％（138/173，95％CI68-88％），而Bosniakv2019IV类囊性肿块的恶性肿瘤比例为84％（114/135，95％CI77-90％）。•III类囊性肿块与不规则有相似的恶性肿瘤比例（83%，97/117，95%CI75-89%）与波斯尼亚IV类质量（84%，114/135，95％CI77-90％）总体（p=0.74），在急性和钝角的IV级肿块内没有差异（p=0.62）。
