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Abstract：
BACKGROUND: Up until now, no research has been reported on the association between the clinical growth rate of multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) and computed tomography (CT) imaging characteristics. Our study sought to examine the correlation between them, with the objective of distinguishing unique features of MCRNLMP from renal cysts and exploring effective management strategies.
OBJECTIVE: To investigate optimal management strategies of MCRNLMP.
METHODS: We retrospectively collected and analyzed data from 1520 patients, comprising 1444 with renal cysts and 76 with MCRNLMP, who underwent renal cyst decompression, radical nephrectomy, or nephron-sparing surgery for renal cystic disease between January 2013 and December 2021 at our institution. Detection of MCRNLMP utilized the Bosniak classification for imaging and the 2016 World Health Organization criteria for clinical pathology.
RESULTS: Our meticulous exploration has revealed compelling findings on the occurrence of MCRNLMP. Precisely, it comprises 1.48% of all cases involving simple renal cysts, 5.26% of those with complex renal cysts, and a noteworthy 12.11% of renal tumors coexisting with renal cysts, indicating a statistically significant difference (P = 0.001). Moreover, MCRNLMP constituted a significant 22.37% of the patient population whose cysts demonstrated a rapid growth rate of ≥ 2.0 cm/year, whereas it only represented 0.66% among those with a growth rate below 2.0 cm/year. Of the 76 MCRNLMP cases studied, none of the nine patients who underwent subsequent nephron-sparing surgery or radical nephrectomy following renal cyst decompression experienced recurrence or metastasis. In the remaining 67 patients, who were actively monitored over a 3-year postoperative period, only one showed suspicious recurrence on CT scans.
CONCLUSIONS: MCRNLMP can be tentatively identified and categorized into three types based on CT scanning and growth rate indicators. In treating MCRNLMP, partial nephrectomy is preferred, while radical nephrectomy should be minimized. After surgery, active monitoring is advisable to prevent unnecessary nephrectomy.
OBJECTIVE: To investigate optimal management strategies of MCRNLMP.
METHODS: We retrospectively collected and analyzed data from 1520 patients, comprising 1444 with renal cysts and 76 with MCRNLMP, who underwent renal cyst decompression, radical nephrectomy, or nephron-sparing surgery for renal cystic disease between January 2013 and December 2021 at our institution. Detection of MCRNLMP utilized the Bosniak classification for imaging and the 2016 World Health Organization criteria for clinical pathology.
RESULTS: Our meticulous exploration has revealed compelling findings on the occurrence of MCRNLMP. Precisely, it comprises 1.48% of all cases involving simple renal cysts, 5.26% of those with complex renal cysts, and a noteworthy 12.11% of renal tumors coexisting with renal cysts, indicating a statistically significant difference (P = 0.001). Moreover, MCRNLMP constituted a significant 22.37% of the patient population whose cysts demonstrated a rapid growth rate of ≥ 2.0 cm/year, whereas it only represented 0.66% among those with a growth rate below 2.0 cm/year. Of the 76 MCRNLMP cases studied, none of the nine patients who underwent subsequent nephron-sparing surgery or radical nephrectomy following renal cyst decompression experienced recurrence or metastasis. In the remaining 67 patients, who were actively monitored over a 3-year postoperative period, only one showed suspicious recurrence on CT scans.
CONCLUSIONS: MCRNLMP can be tentatively identified and categorized into three types based on CT scanning and growth rate indicators. In treating MCRNLMP, partial nephrectomy is preferred, while radical nephrectomy should be minimized. After surgery, active monitoring is advisable to prevent unnecessary nephrectomy.
摘要：
背景：到目前为止，尚无关于低恶性潜能多房性囊性肾肿瘤(MCRNLMP)的临床生长速率与计算机断层扫描(CT)影像学特征之间的相关性的研究报告.我们的研究试图检查它们之间的相关性，目的是区分MCRNLMP与肾囊肿的独特特征，并探索有效的治疗策略。
目的：探讨MCRNLMP的优化管理策略。
方法：我们回顾性收集并分析了1520例患者的数据，包括1444例肾囊肿和76例MCRNLMP，他接受了肾囊肿减压术，根治性肾切除术,或在2013年1月至2021年12月期间在我们机构治疗肾囊性疾病的保留肾单位手术。MCRNLMP的检测利用波什尼亚克分类进行成像和2016年世界卫生组织临床病理学标准。
结果：我们的细致探索揭示了关于MCRNLMP发生的令人信服的发现。准确地说，占所有单纯性肾囊肿病例的1.48%,复杂肾囊肿者占5.26%,值得注意的是12.11%的肾肿瘤与肾囊肿共存，表明统计学上的显著差异(P=0.001)。此外，MCRNLMP占囊肿快速生长速率≥2.0cm/年的患者群体的22.37%，而在增长率低于2.0厘米/年的人群中，这一比例仅为0.66%。在研究的76例MCRNLMP病例中，9例接受肾囊肿减压术后保留肾单位手术或根治性肾切除术的患者均未出现复发或转移.在其余67名患者中，他们在术后3年期间受到积极监测，只有1人在CT扫描中显示可疑复发.
结论：MCRNLMP可以根据CT扫描和生长速率指标初步鉴定并分为三种类型。在治疗MCRNLMP时，首选肾部分切除术，同时应尽量减少根治性肾切除术。手术后,积极监测是可取的，以防止不必要的肾切除术。
目的：探讨MCRNLMP的优化管理策略。
方法：我们回顾性收集并分析了1520例患者的数据，包括1444例肾囊肿和76例MCRNLMP，他接受了肾囊肿减压术，根治性肾切除术,或在2013年1月至2021年12月期间在我们机构治疗肾囊性疾病的保留肾单位手术。MCRNLMP的检测利用波什尼亚克分类进行成像和2016年世界卫生组织临床病理学标准。
结果：我们的细致探索揭示了关于MCRNLMP发生的令人信服的发现。准确地说，占所有单纯性肾囊肿病例的1.48%,复杂肾囊肿者占5.26%,值得注意的是12.11%的肾肿瘤与肾囊肿共存，表明统计学上的显著差异(P=0.001)。此外，MCRNLMP占囊肿快速生长速率≥2.0cm/年的患者群体的22.37%，而在增长率低于2.0厘米/年的人群中，这一比例仅为0.66%。在研究的76例MCRNLMP病例中，9例接受肾囊肿减压术后保留肾单位手术或根治性肾切除术的患者均未出现复发或转移.在其余67名患者中，他们在术后3年期间受到积极监测，只有1人在CT扫描中显示可疑复发.
结论：MCRNLMP可以根据CT扫描和生长速率指标初步鉴定并分为三种类型。在治疗MCRNLMP时，首选肾部分切除术，同时应尽量减少根治性肾切除术。手术后,积极监测是可取的，以防止不必要的肾切除术。
