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一例与肺癌相关的膜性肾小球病及文献复习

A case of membranous glomerulopathy associated with lung cancer and review of the literature.

作者信息

Aytekin Aydin, Ozet Ahmet, Bilgetekin Irem, Ogut Betul, Ciltas Aydin, Benekli Mustafa

机构信息

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara 06560, Turkey.

Department of Pathology, Gazi University Faculty of Medicine, Ankara 06560, Turkey.

出版信息

Mol Clin Oncol. 2017 Aug;7(2):241-243. doi: 10.3892/mco.2017.1295. Epub 2017 Jun 21.

Abstract

Membraneous nephropathy (MN) is the most commonly occurring nephrotic syndrome in adults as well as the most common paraneoplastic nephropathy associated with solid tumors, and it is mostly associated with gastrointestinal system and lung carcinomas. Accurate diagnosis is important as the treatment of paraneoplastic glomerulonephritis is very varied from that of idiopathic ones. In the current report, a case of a patient that was referred with proteinuria and edema and was diagnosed with lung cancer, and responded markedly to treatment of malignancy, with improvement of MN, is presented. Active cancer is present in all patients with paraneoplastic MN. In numerous patients, the paraneoplastic MN and cancer diagnoses are made within one year of each other. The treatment of paraneoplastic syndromes is usually associated with the treatment of primary malignancy. There are conflicting data on which treatment modality is more suitable. In conclusion, further studies are required in order to determine the actual incidence of cancer in patients with nephropathy, explain the physiopathological association between cancer and nephropathy and to determine the most suitable treatment approaches.

摘要

膜性肾病(MN)是成人中最常见的肾病综合征,也是与实体瘤相关的最常见的副肿瘤性肾病,且大多与胃肠道系统和肺癌相关。准确诊断很重要,因为副肿瘤性肾小球肾炎的治疗与特发性肾小球肾炎的治疗差异很大。在本报告中,介绍了一例因蛋白尿和水肿就诊、被诊断为肺癌且对恶性肿瘤治疗反应显著、膜性肾病得到改善的患者。所有副肿瘤性膜性肾病患者均存在活动性癌症。在众多患者中,副肿瘤性膜性肾病和癌症的诊断在彼此一年内作出。副肿瘤综合征的治疗通常与原发性恶性肿瘤的治疗相关。关于哪种治疗方式更合适,存在相互矛盾的数据。总之,需要进一步研究以确定肾病患者中癌症的实际发病率,解释癌症与肾病之间的生理病理关联,并确定最合适的治疗方法。

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