| 【Objective】To explore the clinical application value of Imaging-guided Renal Mass Biopsy for patients with renal tumors.【Methods】We retrospectively collected clinical data of patients with renal tumors who underwent biopsy in the first diagnosis of Fujian Provincial Hospital from January 2012 to July 2020.We collected The diagnostic success rate of percutaneous renal mass biopsy,pathological results and complications Compared the differences in age,gender,tumor characteristics,length of biopsy specimen,and number of biopsy needles between the diagnostic group and the non-diagnostic group.For patients undergoing surgery,surgical pathology was used as the standard to compare the accuracy of biopsy in pathological diagnosis.Analyze the change of the therapeutic plan by renal mass biopsy.【Result】A total of 95 renal mass biopsy patients were collected,68 males and 27 females,aged 2 to 83 years(median age 62 years).All biopsies are obtained with pathological specimens.82 cases(86.3%)in the diagnostic group,of which 72 cases were diagnosed as malignant tumors and 10 cases were benign lesions.Among the malignant tumors,there were 54 cases of renal cell carcinoma,and 43 cases(79.6%)could be classified by pathology.There were 36 cases of renal clear cell carcinoma and papillary renal cell carcinoma,and 34 cases(94.4%)were able to determine the histological grade.12 patients in the diagnostic group underwent surgical treatment and obtained postoperative pathology.Based on the postoperative pathological results,the accuracy of biopsy for determining benign or malignant tumors,pathological types,histological grades was 100%(12/12)and 83.3%(10/12)and 50%(1/2).13 cases(13.5%)in the non-diagnostic group,5 cases were due to puncture into normal kidney tissue(38.4%),3 cases(23.1%)with insufficient specimen volume,2 cases(15.4%)with necrotic hemorrhage tissueand.2 cases(15.4%)in mesenchymal tissue,1 case(7.7%)in Inflammatory infiltratione.There was not statistically significant in age,gender,tumor size,tumor side,puncture specimen length,and number of puncture needles between the diagnostic group and the non-diagnostic group.The two groups had statistically significant in tumor cystic or solid nature(P=0.046)and growth pattern(P=0.043).10cases(10.5%)changed the therapeutic plan by renal mass biopsy.There were 10 cases(10.5%)of complications,including 4 cases of perrenal hematoma(40.0%),1 case of subrenal hematoma(10.0%),1 case of fever(10.0%),1 case of gross hematuria(10.0%),1 case of urinary tract infection(10.0%)and 2 cases of clinically-significant pain(20.0%).No needle tract metastasis was found.【Conclusion】1.Renal mass biopsy has a high diagnostic rate and accuracy for tumor benign and malignant and classification,but the accuracy of histological grading assessment is insufficient.2.Solid versus cystic tumour nature and the growth pattern may be factors influencing the success rate of biopsy diagnosis.3.The main reason why the puncture specimen is difficult to diagnose may be the deviation of the puncture path.4.Renal mass biopsy may change the therapeutic plan for some patients.The following patients are recommended for renal mass biopsy:(1)Patients whose benign or malignant pathological results can change the way of surgery or treatment.(2)Patients with multiple tumors throughout the body to identify the primary tumor.(3)Provide pathological evidences for targeting or ablation therapy.5.The complication rate of renal mass biopsy is low,hematoma is the most common complication. |
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