Fatigati Carmina, Meloni Antonella, Costantini Silvia, Spasiano Anna, Ascione Flora, Cademartiri Filippo, Ricchi Paolo
Rare Red Blood Cells Diseases Unit, Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli", 80131 Naples, Italy.
Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy.
Diagnostics (Basel). 2024 Sep 15;14(18):2047. doi: 10.3390/diagnostics14182047.
We retrospectively collected all ultrasound imaging data of our thalassemia patients over a period of 10 years with the aim of assessing the prevalence and the risk factors of renal stones and cysts. Moreover, we assessed the incidence of renal-cell carcinoma (RCC) among thalassemia patients (133 with thalassemia major (TM) and 157 with thalassemia intermedia (TI)) and its association with demographic and clinical findings. Renal stones were detected in 15.2% of patients. In the multivariable Cox regression analysis, the independent predictors were blood consumption, splenectomy, and proteinuria. Renal cysts were detected in 18.4% of patients. In the multivariable analysis, age emerged as the only independent predictor. After the first detection, 35% of the patients showed changes in the number, size, or grading of renal cysts. During the study period, the crude incidence rate of RCC was 75.9 cases per 100,000 person-years. The most frequent histological subtype (80%) included clear-cell RCC. In total, 80% of patients with RCC had TM and all were positive for hepatitis C virus antibodies. Thalassemia patients are significantly affected by asymptomatic renal diseases such as stones, cysts, and cancer, suggesting the need for regular screening by imaging.
我们回顾性收集了10年间地中海贫血患者的所有超声成像数据，目的是评估肾结石和肾囊肿的患病率及危险因素。此外，我们评估了地中海贫血患者（133例重型地中海贫血（TM）和157例中间型地中海贫血（TI））中肾细胞癌（RCC）的发病率及其与人口统计学和临床发现的关联。15.2%的患者检测到肾结石。在多变量Cox回归分析中，独立预测因素为输血、脾切除术和蛋白尿。18.4%的患者检测到肾囊肿。在多变量分析中，年龄是唯一的独立预测因素。首次检测后，35%的患者肾囊肿数量、大小或分级出现变化。在研究期间，RCC的粗发病率为每10万人年75.9例。最常见的组织学亚型（80%）为透明细胞RCC。总体而言，80%的RCC患者患有TM，且均为丙型肝炎病毒抗体阳性。地中海贫血患者受到结石、囊肿和癌症等无症状肾脏疾病的显著影响，这表明需要通过影像学进行定期筛查。
