回顾临床采用透明细胞似然评分 (ccLS) 从小肾肿块 (SRM) 中识别透明细胞肾细胞癌 (ccRCC) 的证据。我们通过使用 PubMed、Embase、 Web of Science、中国国家知识基础设施和万方数据截止日期为 2024 年 3 月 31 日。使用改良的诊断准确性研究质量评估 (QUADAS-2) 工具评估了应用的偏倚风险和担忧。支持临床采用 ccLS 识别 ccRCC 的证据水平是根据荟萃分析确定的。其中包括八项 MRI 研究和三项 CT 研究。偏倚和应用的风险主要与指标测试、流程和时机有关，原因是影像方案不完整、评级过程不明确、影像与手术间隔不适当。 MRI 和 CT ccLS 的诊断比值比（95% 置信区间）分别为 14.69（9.71-22.22；6 项研究，1429 SRM，869 ccRCC）和 5.64（3.34-9.54；3 项研究，296 SRM，147 ccRCC） ，用于从 SRM 中识别 ccRCC。 MRI 和 CT ccLS 临床采用的证据水平均被评为弱。 MRI ccLS 2.0 版可能比 1.0 版具有更好的诊断性能（1 项研究，700 个 SRM，509 个 ccRCC）。有或没有脂肪抑制的 T2 加权成像可能都适合 MRI ccLS 版本 2.0（1 项研究，111 项 SRM，82 ccRCC）。ccLS 在从 SRM 中识别 ccRCC 方面显示出有希望的诊断性能，但其在临床常规中采用的证据尽管透明细胞似然评分 (ccLS) 在检测透明细胞肾细胞癌方面表现出良好的性能，但额外的证据对于支持其作为小肾肿块的初步诊断和主动监测工具的常规使用至关重要。透明细胞似然评分设计用于评估小肾脏肿块。 CT 和 MRI 透明细胞似然评分均准确且高效。临床采用透明细胞似然评分需要更多证据。© 2024。作者。

To review the evidence for clinical adoption of clear cell likelihood score (ccLS) for identifying clear cell renal cell carcinoma (ccRCC) from small renal masses (SRMs).We distinguished the literature on ccLS for identifying ccRCC via systematic search using PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang Data until 31 March, 2024. The risk of bias and concern on application was assessed using the modified quality assessment of diagnostic accuracy studies (QUADAS-2) tool. The level of evidence supporting the clinical adoption of ccLS for identifying ccRCC was determined based on meta-analyses.Eight MRI studies and three CT studies were included. The risk of bias and application were mainly related to the index test and flow and timing, due to incomplete imaging protocol, unclear rating process, and inappropriate interval between imaging and surgery. The diagnostic odds ratios (95% confidence intervals) of MRI and CT ccLS were 14.69 (9.71-22.22; 6 studies, 1429 SRM, 869 ccRCC), and 5.64 (3.34-9.54; 3 studies, 296 SRM, 147 ccRCC), respectively, for identifying ccRCC from SRM. The evidence level for clinical adoption of MRI and CT ccLS were both rated as weak. MRI ccLS version 2.0 potentially has better diagnostic performance than version 1.0 (1 study, 700 SRM, 509 ccRCC). Both T2-weighted-imaging with or without fat suppression might be suitable for MRI ccLS version 2.0 (1 study, 111 SRM, 82 ccRCC).ccLS shows promising diagnostic performance for identifying ccRCC from SRM, but the evidence for its adoption in clinical routine remains weak.Although clear cell likelihood score (ccLS) demonstrates promising performance for detecting clear cell renal cell carcinoma, additional evidence is crucial to support its routine use as a tool for both initial diagnosis and active surveillance of small renal masses.Clear cell likelihood score is designed for the evaluation of small renal masses. Both CT and MRI clear cell likelihood scores are accurate and efficient. More evidence is necessary for the clinical adoption of a clear cell likelihood score.© 2024. The Author(s).