The RENAL Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth
The RENAL Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth
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DOI：
10.1016/j.juro.2009.05.035
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发表时间：
2009-09-01
影响因子：
6.6
通讯作者：
Uzzo, Robert G.
中科院分区：
文献类型：
--
作者：
Kutikov, Alexander;Uzzo, Robert G.
目的：肾脏恶性肿瘤的治疗决策在很大程度上取决于定性数据，包括对肿瘤解剖的描述和治疗外科医生的经验。目前，肾肿瘤解剖要素的描述是描述性的，缺乏标准化。通过一个一致的、可重复性的系统来量化局部肾脏病变的相关特征，手术决策和数据集比较将得到显著的加强。我们开发并提出了一种标准化的肾脏测量评分系统(R.E.N.A.L.Nephroomy Score)，用于在计算机断层扫描/磁共振成像上对肾脏肿块的解剖特征进行量化。材料和方法：肾脏测量评分基于实体肾肿块的5个关键和可重复的解剖特征。在5个部分中，4个部分按1、2或3分标准进行评分，第5个部分表示肿块相对于肾脏冠状面的前部或后部位置。结果：采用R.E.N.A.L.散射比浊法对福克斯·蔡斯癌症中心连续切除的50个肿块进行测量。结果：R.E.N.A.L.散射比浊法包括(R)肿瘤直径(肿瘤最大直径)，(E)肿瘤的滋生/内生性质，(N)肿瘤最深处到集合系统或鼻窦的位置，(A)前(A)/后(P)描述符和(L)相对于极线的位置。后缀h(肺门)是指与主肾动脉或静脉相邻的肿瘤。肾测量评分系统对我们机构连续切除的50例肿瘤的复杂性进行了准确的分类。结论：标准化的报告肾脏肿瘤的大小、位置和深度对于决策和有效的比较是必不可少的。R.E.N.A.L.肾度学评分是一种可重复使用的标准化分类系统，用于量化肾脏肿块的显著解剖结构。这一新的方法系统地描述了肾脏肿瘤的特征，为临床实践和泌尿学文献中肾脏肿块的有意义的比较提供了工具。
Purpose: Treatment decisions for renal malignancies depend largely on qualitative data, including a description of tumor anatomy and the experience of the treating surgeon. Currently characterization of renal tumor anatomical elements is descriptive and lacks standardization. Surgical decision making and data set comparisons would be significantly enhanced by a consistent, reproducible system that quantitates the pertinent characteristics of localized renal lesions. We have developed and propose a standardized nephrometry scoring system (R.E.N.A.L. Nephrometry Score) to quantify the anatomical characteristics of renal masses on computerized tomography/magnetic resonance imaging.Materials and Methods: The nephrometry score is based on 5 critical and reproducible anatomical features of solid renal masses. Of the 5 components 4 are scored on a 1, 2 or 3-point scale with the 5th indicating the anterior or posterior location of the mass relative to the coronal plane of the kidney. We applied the R.E.N.A.L. Nephrometry Score to 50 consecutive masses resected at Fox Chase Cancer Center.Results: The R.E.N.A.L. Nephrometry Score consists of (R)adius (tumor size as maximal diameter), (E)xophytic/endophytic properties of the tumor, (N)earness of tumor deepest portion to the collecting system or sinus, (A)nterior (a)/posterior (p) descriptor and the (L)ocation relative to the polar line. The suffix h (hilar) is assigned to tumors that abut the main renal artery or vein. The nephrometry scoring system accurately classified the complexity of 50 consecutive tumors undergoing excision at our institution.Conclusions: Standardized reporting of renal tumor size, location and depth is essential for decision making and effective comparisons. The R.E.N.A.L. Nephrometry Score is a reproducible standardized classification system that quantitates the salient anatomy of renal masses. This novel approach for the systematic characterization of renal tumors provides a tool for meaningful comparisons of renal masses in clinical practice and in the urological literature.