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目的:研究在中国患者中术前影像学诊断肾癌行肾脏部分切除手术或根治性肾切除手术的肾脏良性占位病变发生率,并分析其预测因素。方法:回顾性分析从2003年1月～2010年9月共1 531例术前影像学诊断为肾癌并行肾脏部分切除手术或根治性肾切除手术患者的临床资料,多因素回归分析术后病理检查证实为良性患者的临床病理资料。结果:在1 531例患者中,共有81例(5.3%)为良性,其中包括错构瘤52例(3.4%),嗜酸细胞腺瘤12例(0.8%),复杂性囊肿6例(0.3%),其他类型11例(0.7%)。单因素分析显示女性、肿瘤最大径较小、年龄较小、囊性占位病变为临床表现者,病理检查证实为良性的可能性大。多因素回归分析显示,女性(OR,3.13;95%CI,1.95～5.04;P<0.001)、肿瘤最大径较小(OR,0.75;95%CI,0.66～0.85;P<0.001)、年龄较小(OR,0.94;95%CI,0.92～0.96;P<0.001)是良性占位病变的独立预测因素,而囊性占位病变不是显著性预测因素。结论:在中国患者中,术前影像学检查诊断为肾癌术后病理检查证实为良性病变的发生率为5.3%,较国外同类研究明显偏低。良性占位病变中最常见的类型为错构瘤,而欧美同类研究中为嗜酸细胞腺瘤。女性、年龄较小、肿瘤最大径较小是良性占位病变的独立预测因素。
Objective: To study the prevalence of benign space-occupying lesions in kidney patients undergoing partial nephrectomy or radical nephrectomy for preoperative imaging in Chinese patients, and to analyze their predictive factors. METHODS: A retrospective analysis was performed from January 2003 to September 2010 in 1 531 patients with preoperative imaging diagnosis of renal cell carcinoma with concurrent partial nephrectomy or radical nephrectomy. Multivariate regression analysis of postoperative pathology The examination confirmed the clinical pathological data of benign patients. RESULTS: Of the 1 531 patients, 81 (5.3%) were benign, including 52 hamartomas (3.4%), 12 eosinophil adenomas (0.8%), and 6 complicated cysts (0.3 %), 11 other cases (0.7%). Univariate analysis showed that women, tumors with smaller diameters, younger ages, and cystic lesions were clinical manifestations. It was highly likely that pathological findings were benign. Multivariate regression analysis showed that women (OR, 3.13; 95% CI, 1.95 to 5.04; P<0.001) had a smaller maximum tumor diameter (OR, 0.75; 95% CI, 0.66 to 0.85; P<0.001) and had a relatively young age. Small (OR, 0.94; 95% CI, 0.92 to 0.96; P<0.001) was an independent predictor of benign lesions, whereas cystic lesions were not a significant predictor. Conclusion: In Chinese patients, the incidence of benign lesions confirmed by preoperative imaging examination for pathological examination of renal cell carcinoma was 5.3%, which was significantly lower than that of similar foreign studies. The most common type of benign space-occupying lesions is hamartoma, whereas eosinophil adenomas are found in similar studies in Europe and America. Women, younger age, and smaller maximum tumor size were independent predictors of benign lesions.