Ertugrul SEFİK, İbrahim Halil BOZKURT, Gülşen Yücel OĞUZDOĞAN, Mehmet Erhan AYDIN, Serdar ÇELİK, İsmail BASMACI, Sacit Nuri GÖRGEL, Bülent GÜNLÜSOY, Tansu DEĞİRMENCİ

Bosniak Kategori 3 Kistik Kitlelerde Malignite Göstergesi Olarak Lezyon Boyutunun Önemi

Amaç: Cerrahi olarak çıkarılan Bosniak 3 renal kistlerde lezyon boyutunun malignite ile ilişkisini değerlendirmek Gereç ve Yöntemler: Ocak 2010 ve Aralık 2018 tarihleri arasında kistik renal kitle nedeniyle radikal/parsiyel nefrektomi yapılan hastalar retrospektif olarak incelendi. Preoperatif bilgisayarlı tomografi (BT) ve/veya Magnetik Resonans Görüntüleme (MRG) görüntülerinde Bosniak 3 olarak değerlendirilen 52 hasta çalışmaya dahil edildi. Bosniak 3 lezyonlar arasında ROC Curve analizi yapılarak maligniteyi öngören tümör boyutu cut-off değeri bulundu. Bu değerin altında ve üstünde tümör boyutuna sahip hastalar hasta karakteristikleri ve histopatolojik veriler açısından karşılaştırıldı. Bulgular: Ortalama hasta yaşı 54.2±13.1 ve ortalama takip süresi 39.9±25.2 aydı. Tüm Bosniak 3 lezyonlar için malignite oranı 63.5% olarak gözlendi. Malign ve benign patolojisi olan hastaların hasta karakteristiklerine göre karşılaştırılmasında erkek cinsiyet ve düşük tümör boyutu hem tek değişkenli hem de çok değişkenli analizde malignite ile ilişkili olarak olarak bulundu. ROC Curve analizinde maligniteyi öngören kist boyutu cut-off değeri 45 mm saptandı (AUC=0.735, p=0.005). Tümör boyutu ≤45 mm (Grup 1) ve >45 mm (Grup 2) olmasına göre hastalar iki gruba ayrıldı. Malignite oranı iki grupta sırasıyla 77.8% ve 48% olarak bulundu (p=0.026, OR:0.26, CI:0.079-0.875). Sonuç: Bosniak 3 böbrek kistlerinde düşük tümör boyutu malignite göstergesi olarak bulunmuştur.

Anahtar Kelimeler:

böbrek kistleri, Bosniak sınıflaması, lezyon boyutu, malignite

The Importance of Lesion Size as an Indicator of Malignancy in Bosniak Category 3 Cystic Renal Masses

Objective: To evaluate the relationship between lesion size and malignancy rates in surgically removed Bosniak 3 renal cysts.Material and Methods: Patients who underwent radical / partial nephrectomy for cystic renal mass between January 2010 and December 2018 were retrospectively analyzed. Fifty two patients who were diagnosed as Bosniak 3 renal cyst in preoperative computed tomography (CT) and / or Magnetic Resonance Imaging (MRI) images were included in the study. ROC Curve analysis was performed among Bosniak 3 lesions and tumor size cut-off value predicting malignancy was found. Patients with tumor size below and above this value were compared in terms of patient characteristics and histopathological data.Results: The mean patient age was 54.2 ± 13.1 years and the mean follow-up period was 39.9 ± 25.2 months. The malignancy rate for all Bosniak 3 lesions was 63.5%. Male gender and low tumor size were correlated with malignancy in both univariate and multivariate analysis in comparison of patients with malignant and benign pathology. In the ROC Curve analysis, the cut-off value of the cyst, which predicted malignancy, was 45 mm (AUC = 0.735, p = 0.005). Patients were divided into two groups according to tumor size ≤45 mm (Group 1) and > 45 mm (Group 2). The malignancy rate was 77.8% and 48% in Group 1 and 2, respectively (p = 0.026, OR: 0.26, CI: 0.079-0.875).Conclusion: In Bosniak 3 renal cysts, low tumor size was found to be associated with malignancy.

Keywords:

Renal cysts, osniak classification, lesion size, malignancy,

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