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Abstract：
UNASSIGNED: Renal mass biopsy (RMB) has regained clinical interest in recent years due to the pursuit of individualized and precision medicine. Renal mass core needle biopsy (RMCNB) for histopathology (HP), with or without liquid-based cytology (LBC), has been used increasingly in our hospital. This study investigated factors influencing the HP diagnostic yield of RMCNB, and compared the diagnostic rate between HP alone and HP plus LBC.
UNASSIGNED: In this retrospective cross-sectional study, a total of 134 patients who underwent ultrasound-guided percutaneous RMCNB in the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 and May 2022 were enrolled. All biopsies were performed using an 18-gauge core needle biopsy gun, and the sampling tissues and exfoliative cells of 18-gauge core needle groove were delivered for HP and LBC diagnosis, respectively. The patient demographics, clinical indications, tumor characteristics, number of biopsies, final pathological diagnosis, and follow-up data were reviewed. Univariate and multivariate logistic regression analyses were performed to evaluate the association between variables and HP diagnostic yield of RMCNB. The diagnostic rate between HP and HP plus LBC was compared using McNemar\'s test and agreement was evaluated using the Kappa score.
UNASSIGNED: The most common indication of RMCNB was renal masses with a radiological diagnosis of locally advanced disease or distant metastasis (86.6%). The HP diagnostic yield was established in 88.1% (118/134) of cases, and the diagnostic rate of HP plus LBC was 94.0% (126/134). Logistic regression analyses revealed that non-enhanced area exceeding 50% [odds ratio (OR): 0.021, 95% confidence interval (CI): 0.003-0.134, P<0.001] and number of core biopsies (OR: 9.479, 95% CI: 1.528-58.794, P=0.016) were associated with the HP diagnostic yield of RMCNB. The diagnostic rate of HP plus LBC was significantly higher than that of HP alone (94.0% vs. 88.1%, P=0.008), and they showed substantial agreement (Kappa =0.638, P<0.001). Meanwhile, in the non-enhanced area ≥50% subgroup, the diagnostic rate between HP plus LBC and HP alone was significantly different (86.7% vs. 60%, P=0.008), and the agreement was fair (Kappa =0.375, P=0.009).
UNASSIGNED: RMCNB has a high diagnostic yield with a minimum of two high-quality core biopsies, LBC can improve the diagnostic yield of HP alone, especially in masses with large non-enhanced area.
UNASSIGNED: In this retrospective cross-sectional study, a total of 134 patients who underwent ultrasound-guided percutaneous RMCNB in the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 and May 2022 were enrolled. All biopsies were performed using an 18-gauge core needle biopsy gun, and the sampling tissues and exfoliative cells of 18-gauge core needle groove were delivered for HP and LBC diagnosis, respectively. The patient demographics, clinical indications, tumor characteristics, number of biopsies, final pathological diagnosis, and follow-up data were reviewed. Univariate and multivariate logistic regression analyses were performed to evaluate the association between variables and HP diagnostic yield of RMCNB. The diagnostic rate between HP and HP plus LBC was compared using McNemar\'s test and agreement was evaluated using the Kappa score.
UNASSIGNED: The most common indication of RMCNB was renal masses with a radiological diagnosis of locally advanced disease or distant metastasis (86.6%). The HP diagnostic yield was established in 88.1% (118/134) of cases, and the diagnostic rate of HP plus LBC was 94.0% (126/134). Logistic regression analyses revealed that non-enhanced area exceeding 50% [odds ratio (OR): 0.021, 95% confidence interval (CI): 0.003-0.134, P<0.001] and number of core biopsies (OR: 9.479, 95% CI: 1.528-58.794, P=0.016) were associated with the HP diagnostic yield of RMCNB. The diagnostic rate of HP plus LBC was significantly higher than that of HP alone (94.0% vs. 88.1%, P=0.008), and they showed substantial agreement (Kappa =0.638, P<0.001). Meanwhile, in the non-enhanced area ≥50% subgroup, the diagnostic rate between HP plus LBC and HP alone was significantly different (86.7% vs. 60%, P=0.008), and the agreement was fair (Kappa =0.375, P=0.009).
UNASSIGNED: RMCNB has a high diagnostic yield with a minimum of two high-quality core biopsies, LBC can improve the diagnostic yield of HP alone, especially in masses with large non-enhanced area.
摘要：
■近年来，由于对个体化和精准医学的追求，肾脏肿块活检（RMB）重新获得了临床兴趣。肾肿块穿刺活检（RMCNB）用于组织病理学（HP），有或没有液基细胞学（LBC），我们医院越来越多地使用。本研究调查了影响RMCNBHP诊断率的因素，并比较单独HP和HP加LBC的诊断率。
■在这项回顾性横断面研究中，在国家癌症中心/国家癌症临床研究中心/肿瘤医院接受超声引导经皮RMCNB治疗的134例患者，2015年1月至2022年5月，中国医学科学院和北京协和医学院入选。所有活检均使用18号芯针活检枪进行，并将18号针槽的取样组织和脱落细胞用于HP和LBC诊断，分别。病人的人口统计，临床适应症,肿瘤特征，活检的数量，最终病理诊断，并对随访数据进行了回顾。进行单变量和多变量逻辑回归分析以评估变量与RMCNB的HP诊断率之间的关联。使用McNemar检验比较HP和HP加LBC的诊断率，并使用Kappa评分评估一致性。
■RMCNB最常见的适应症是肾脏肿块，放射学诊断为局部晚期疾病或远处转移（86.6％）。在88.1%(118/134)的病例中建立了HP诊断率，HP加LBC的诊断率为94.0%(126/134)。Logistic回归分析显示，超过50％的非增强区域[比值比（OR）：0.021，95％置信区间（CI）：0.003-0.134，P<0.001]和核心活检数量（OR：9.479，95％CI：1.528-58.794，P=0.016）与RCNB的HP诊断率相关。HP加LBC的诊断率明显高于单纯HP(94.0%vs.88.1%,P=0.008),他们表现出基本一致（Kappa=0.638，P<0.001）。同时,在非增强区≥50%亚组，HP加LBC与单纯HP的诊断率有显著差异(86.7%vs.60%,P=0.008),并且协议是公平的（Kappa=0.375，P=0.009）。
■RMCNB具有较高的诊断率，至少需要两次高质量的核心活检，LBC可以单独提高HP的诊断率，特别是在大的非增强面积的群众。
■在这项回顾性横断面研究中，在国家癌症中心/国家癌症临床研究中心/肿瘤医院接受超声引导经皮RMCNB治疗的134例患者，2015年1月至2022年5月，中国医学科学院和北京协和医学院入选。所有活检均使用18号芯针活检枪进行，并将18号针槽的取样组织和脱落细胞用于HP和LBC诊断，分别。病人的人口统计，临床适应症,肿瘤特征，活检的数量，最终病理诊断，并对随访数据进行了回顾。进行单变量和多变量逻辑回归分析以评估变量与RMCNB的HP诊断率之间的关联。使用McNemar检验比较HP和HP加LBC的诊断率，并使用Kappa评分评估一致性。
■RMCNB最常见的适应症是肾脏肿块，放射学诊断为局部晚期疾病或远处转移（86.6％）。在88.1%(118/134)的病例中建立了HP诊断率，HP加LBC的诊断率为94.0%(126/134)。Logistic回归分析显示，超过50％的非增强区域[比值比（OR）：0.021，95％置信区间（CI）：0.003-0.134，P<0.001]和核心活检数量（OR：9.479，95％CI：1.528-58.794，P=0.016）与RCNB的HP诊断率相关。HP加LBC的诊断率明显高于单纯HP(94.0%vs.88.1%,P=0.008),他们表现出基本一致（Kappa=0.638，P<0.001）。同时,在非增强区≥50%亚组，HP加LBC与单纯HP的诊断率有显著差异(86.7%vs.60%,P=0.008),并且协议是公平的（Kappa=0.375，P=0.009）。
■RMCNB具有较高的诊断率，至少需要两次高质量的核心活检，LBC可以单独提高HP的诊断率，特别是在大的非增强面积的群众。
