Tanariyakul Manasawee, Saowapa Sakditad, Aiumtrakul Noppawit, Wannaphut Chalothorn, Polpichai Natchaya, Siladech Pharit
Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Proc (Bayl Univ Med Cent). 2024 Jul 16;37(5):832-838. doi: 10.1080/08998280.2024.2375705. eCollection 2024.
Renal transplant recipients confront a substantially elevated susceptibility to renal cell carcinoma (RCC), particularly in their native kidneys as opposed to allografts.
In this systematic scoping review, exhaustive searches were conducted of the MEDLINE and EMBASE databases. Information was gathered on clinical manifestations, donor demographics, diagnostic intervals, tumor dimensions, histopathological characteristics, and therapeutic outcomes associated with RCC arising in allograft kidneys.
The searches yielded a corpus of 42 case reports and 11 retrospective cohorts, encompassing a cohort of 274 patients. The majority of cases (75.4%) were clinically latent, discerned primarily through imaging modalities. Symptomatic presentations encompassed manifestations such as hematuria, elevated serum creatinine levels, abdominal discomfort, and graft-related pain. The mean temporal interval between renal transplantation and RCC diagnosis was calculated at 11.6 years, albeit displaying considerable variance. Notably, papillary and clear cell RCC emerged as the prevailing histopathological subtypes. However, the paucity of longitudinal follow-up data represents a notable caveat.
This investigation underscores the imperative of rigorous posttransplant surveillance regimes owing to the substantial prevalence of asymptomatic RCC instances. Future research should focus on clinical outcomes and cost-effectiveness of screening practices to develop preventive strategies.
肾移植受者患肾细胞癌（RCC）的易感性显著升高，尤其是在其自身肾脏而非同种异体移植肾中。
在这项系统性范围综述中，对MEDLINE和EMBASE数据库进行了全面检索。收集了关于同种异体移植肾中发生的RCC的临床表现、供体人口统计学特征、诊断间隔、肿瘤大小、组织病理学特征和治疗结果的信息。
检索产生了42篇病例报告和11个回顾性队列，涵盖274例患者。大多数病例（75.4%）临床上无明显症状，主要通过影像学检查发现。有症状的表现包括血尿、血清肌酐水平升高、腹部不适和移植相关疼痛等。肾移植与RCC诊断之间的平均时间间隔计算为11.6年，尽管存在相当大的差异。值得注意的是，乳头状和透明细胞RCC是主要的组织病理学亚型。然而，缺乏纵向随访数据是一个明显的问题。
这项调查强调了由于无症状RCC病例的大量存在，严格的移植后监测制度的必要性。未来的研究应关注筛查实践的临床结果和成本效益，以制定预防策略。
