活检证实瘤性脏瘤的积极监测:生长动态和对脏功能的影响
Lucshman Raveendran1, Lisa J Martin2, Douglas C Cheung1
1Division of Urology, Department of Surgery, University of Toronto, Toronto, Canada.
The Journal of urology
|August 8, 2025
概括
通过积极监测管理的瘤细胞性瘤显示生长缓慢和干预率低. 这种方法有效地保持了功能,并提供了很好的生存结果,支持其在临床实践中的使用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 细胞性瘤占小质中15%的比例.
- 积极监测 (AS) 越来越多地用于这些病变,但对生长模式,活检准确性和功能影响的数据有限.
研究的目的:
- 为了评估生长动力学,活检一致性和瘤细胞瘤瘤在主动监测下管理的功能影响.
- 在AS下分析最大的一组活检确认的瘤细胞瘤瘤.
主要方法:
- 从2003年至2021年,对生检确认细胞瘤或染色性细胞癌 (chRCC) 的AS患者进行了回顾性分析.
- 使用线性混合模型分析的瘤生长率和估计的膜过率 (eGFR) 变化.
- 检查了活检与手术病理一致性和干预触发因素.
主要成果:
- 预计瘤细胞瘤的增长率为0.21厘米/年,慢性肺癌的增长率为0.31厘米/年.
- 瘤细胞瘤的活检与病理学一致性为80%,慢性肺癌的一致性为86%.
- 没有观察到瘤大小和功能下降之间的显著关联; 观察到优异的特定疾病生存率.
结论:
- 用AS治疗的瘤细胞病变表现出缓慢的生长,对功能的影响最小,干预率低.
- 基因组学引导的AS是一种有效的瘤性瘤瘤管理策略,尽管有活检限制.
- 这项研究支持AS作为选择瘤瘤瘤瘤瘤的安全和有效选择.
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