Biava C G, Gonwa T A, Naughton J L, Hopper J
Am J Nephrol. 1984;4(4):208-14. doi: 10.1159/000166810.
A review of 80 patients with the renal biopsy diagnosis of idiopathic glomerulonephritis with extracapillary proliferation (crescentic GN) disclosed 7 cases with a coexistent nonrenal malignancy; 6 carcinomas and 1 lymphoma. In a control group of 80 patients with the renal biopsy diagnosis of minimal change or focal segmental glomerulosclerosis, only 1 case of coexistent malignancy was found (chi-square = 4.74, p less than 0.05). All of the malignancies occurred in patients older than 40 years of age and the prevalence of malignancy in patients with crescentic GN over the age of 40 was 20%. Light microscopy, immunofluorescence, and electron microscopy revealed fibrin deposition in all cases and no evidence of anti-GBM or immune complex disease. 3 patients experienced a rapidly progressive course while renal function improved in 4 patients following treatment of the underlying malignancy. The pathogenic mechanisms leading to crescentic GN in patients with malignancy are unknown; however, the high prevalence of malignancy in crescentic GN patients older than 40 along with the improvement during the treatment of the underlying malignancy suggests an etiological relationship.
对80例经肾活检诊断为伴有毛细血管外增生（新月体性肾小球肾炎）的特发性肾小球肾炎患者的回顾发现，有7例同时存在非肾恶性肿瘤；6例为癌，1例为淋巴瘤。在80例经肾活检诊断为微小病变或局灶节段性肾小球硬化的对照组患者中，仅发现1例并存恶性肿瘤（卡方检验=4.74，p<0.05）。所有恶性肿瘤均发生在40岁以上的患者中，40岁以上新月体性肾小球肾炎患者的恶性肿瘤患病率为20%。光镜、免疫荧光和电镜检查显示，所有病例均有纤维蛋白沉积，无抗肾小球基底膜或免疫复合物疾病的证据。3例患者病情呈快速进展，而4例患者在治疗潜在恶性肿瘤后肾功能有所改善。导致恶性肿瘤患者发生新月体性肾小球肾炎的致病机制尚不清楚；然而，40岁以上新月体性肾小球肾炎患者中恶性肿瘤的高患病率以及在治疗潜在恶性肿瘤期间病情的改善提示了一种病因学关系。
