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实体瘤中的肿瘤溶解综合征:临床特征与预后

Tumor lysis syndrome in solid tumors: Clinical characteristics and prognosis.

作者信息

Caravaca-Fontán Fernando, Martínez-Sáez Olga, Pampa-Saico Saúl, Olmedo Maria Eugenia, Gomis Antonio, Garrido Pilar

机构信息

Servicio de Nefrología, Hospital Universitario Ramón y Cajal, Madrid, España.

Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, España.

出版信息

Med Clin (Barc). 2017 Feb 9;148(3):121-124. doi: 10.1016/j.medcli.2016.10.040. Epub 2016 Dec 16.

Abstract

INTRODUCTION AND OBJECTIVE

Tumour lysis syndrome (TLS) is an uncommon complication in solid tumors following treatment initiation, and its spontaneous development (STLS) is exceptional. In this study, we analyse the main clinical and prognostic features of a case series with TLS and STLS.

MATERIAL AND METHODS

Observational retrospective study in which we included all patients with solid tumours diagnosed with TLS and STLS over a period of 16 years, according to Cairo-Bishop criteria.

RESULTS

Nineteen patients were included in the study (mean age 63±16 years): 10 patients (53%) with TLS, and 9 (47%) STLS. The primary tumour in 8 cases (42%) was lung cancer. All patients had severe renal impairment at the time of diagnosis along with hyperuricemia (16±6mg/dl) and hyperkalemia (6±0.9mmol/l). Despite treatment with intravenous fluids, urinary alkalinisation and rasburicase, 3 patients (16%) required dialysis, and 12 (63%) died during the follow-up period.

CONCLUSIONS

The development of TLS in solid tumors is associated with increased mortality and therefore, a high index of suspicion is essential for early diagnosis and treatment initiation.

摘要

引言与目的

肿瘤溶解综合征(TLS)是实体肿瘤治疗开始后一种不常见的并发症,其自发发生(STLS)则更为罕见。在本研究中,我们分析了一组TLS和STLS病例的主要临床及预后特征。

材料与方法

进行观察性回顾性研究,纳入了16年间所有根据开罗-毕晓普标准诊断为实体肿瘤伴TLS和STLS的患者。

结果

本研究纳入了19例患者(平均年龄63±16岁):10例(53%)为TLS患者,9例(47%)为STLS患者。8例(42%)患者的原发肿瘤为肺癌。所有患者在诊断时均有严重肾功能损害,伴有高尿酸血症(16±6mg/dl)和高钾血症(6±0.9mmol/l)。尽管接受了静脉补液、尿液碱化及拉布立酶治疗,但仍有3例患者(16%)需要透析,12例(63%)患者在随访期间死亡。

结论

实体肿瘤中TLS的发生与死亡率增加相关,因此,高度怀疑对于早期诊断和开始治疗至关重要。

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