肿瘤相关膜性肾病患者的临床及免疫病理分析

Abstract
Figure/Table
References (24)
Related Citation (15)

Download: PDF (469 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the differences of clinical and pathological features in patients with tumor-associated membranous nephropathy, so as to guide clinical practice. Methods A retrospective analysis of 102 patients with membranous nephropathy was performed in the Department of Nephrology, People’s Liberation Army General Hospital from January 2017 to December 2018. According to the etiology, they were divided into idiopathic group (91 cases) and tumor group (11 cases), followed up for 24 months. The general clinical data of the two groups were compared, including age, gender, smoking, hypertension, hematuria, and serous cavity effusion, etc.; laboratory tests: 24-hour urine protein quantification, serum albumin, serum creatinine, serum complement C3, C4, serum anti-phospholipase A2 receptor (PLA2R) antibody, etc. renal pathology including membranous nephropathy stage, renal interstitial inflammatory cell infiltration grade, renal tubular atrophy, immunofluorescence IgG1, and IgG4 deposition were recorded. Results The age of the tumor group was higher than that of the idiopathic group, and the difference was statistically significant (P ＜ 0.05). The degree of renal tubular atrophy in the tumor group was higher than that in the idiopathic group, and the difference was statistically significant (P ＜ 0.05). There were no significant differences in the positive rate of IgG4 deposition and the positive rate of anti-PLA2R antibody between the two groups (P ＞ 0.05). Conclusion The positive rate of IgG4 subtype and whether the anti-PLA2R antibody is positive still need to be cautious in distinguishing membranous nephropathy from tumors. In patients with membranous nephropathy with relatively less severe renal tubular damage, potential tumors should be carefully excluded.

Key words： Membranous nephropathy Malignancy Renal pathology Immunohistochemical

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	DONG He１ FENG Zhe2▲

Cite this article:

DONG He１ FENG Zhe2▲. Clinical and immunopathological analysis of patients with tumor-associated membranous nephropathy #br#[J]. 中国医药导报, 2022, 19(16): 109-112.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I16/109

[1] Troyanov S，Roasio L，Pandes M，et al. Renal pathology in idiopathic membranous nephropathy：a new perspective [J]. Kidney Int，2006，69：1641-1648.
[2] 温丽颖，李绍梅，闫哲，等.M型磷脂酶A2受体及1型血小板反应蛋白7A域在成人特发性膜性肾病的表达及意义[J].中华肾脏病杂志，2016，32（8）：561-567.
[3] 张翥，丁庆龙，李炳辰.继发性膜性肾病的病因与治疗[J].中国临床医生杂志，2019，47（9）：1014-1017，1004.
[4] Zhang D，Zhang C，Bian F，et al. Clinicopathological features in membranous nephropathy with cancer ： a retrospective single center study and literature review [J]. Int J Biol Markers，2019，34（4）：406-413.
[5] Zhang CM，Zhang MC，Chen DC，et al. Features of phospholipase A2 receptor and thrombospondin type 1 domain-containing 7A in malignancy-associated membranous nephropathy [J]. J Clin Pathol，2019，72（10）：705-711.
[6] 章友康，王素霞.继发性膜性肾病的病因与诊断[J].肾脏病与透析肾移植杂志，2008，17（3）：254-255.
[7] Leeaphorn N，Kue-A-PaiP，Thamcharoen N，et al. Prevalence of cancer in membranous nephropathy： a systematic review and meta-analysis of observational studies [J]. Am J Nephrol，2014，40（1）：29-35.
[8] Lefaucheu G，Stengel B，Nochy D，et al. Membranous neph-ropathy and cancer：Epidemiologic evidence and determinants of high-risk cancer association [J]. Kidney Int，2006， 70（8）：1510-1517
[9] Beck LH Jr，Bonegio RG，Lambeau G，et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy [J]. N England J Med，2009，361（1）：11-21.
[10] Ohtani H，Wakui H，Komatsuda A，et al. Distribution of glomerular IgG subclass deposits in malignancy-associate membranous nephropathy [J]. Nephrol Dial Transplant，2004，19（3）：574-579
[11] Qu Z，Liu G，Li J，et al. Absence of glomerular IgG4 deposition in patients with membranous nephropathy may indicate malignancy [J]. Nephrol Dial Transplant，2012， 27（5）：1931-1937.
[12] 李世军，秦卫松，张明超，等.肿瘤相关性膜性肾病：抗足细胞自身抗体肾组织IgG亚型的检测[J].肾脏病与透析肾移植杂志，2011，20（1）：12-17.
[13] 王素霞.膜性肾病的病理诊断进展[J].内科急重症杂志，2019，25（4）：268-270.
[14] Qin W，Beck LH，Zeng C，et al. Anti-phospholipase A2 receptor antibody in membranous nephropathy [J]. J Am Soc Nephrol，2011，22：1137-1143.
[15] Iwalura T，Ohashi N，Kato A，et al. Prevalence of enhanced granular expression of thrombospondin type-1 domain -containing 7a in the glomeruli of Japanese patients with idiopathic membranous nephropathy [J]. PLoS One，2015，10（9）：e0138841.
[16] Dong HR，Wang YY，Cheng XH，et al. Retrospective study do phospholipase A2 receptor and IgG subclasses in glomerular deposits in Chinese patients with membranous nephropathy [J]. PLoS One，2016：11（5）：e0156263.
[17] Murtas C，Ghiggeri GM. Membranous glomerulonephritis：histological and serological features to differentiate cancer-related and non-related forms [J]. J Nephrol，2016， 29（4）：469-478.
[18] Sukocheva O，Menschikowski M，Hagelgans A，et al. Current insights in functions of phospholipase A2 receptor in normal and cancer cells： More questions than answers [J]. Semin cancer Biol，2019，56：116-127.
[19] Bernard D，Vindrieux D. PLA2R1：express and function in cancer [J]. Biochim Biophys Acta，2014，1846（1）：40-44.
[20] 祝婉婷，王艳秋.磷脂酶A2受体与肿瘤相关膜性肾病的研究现状[J].临床肾脏病杂志，2021，21（7）：589-593.
[21] 霍飞霞，朱国贞.联合检测尿KIM-1及NGAL在特发性膜性肾病中的应用[J].中国临床研究，2021，34（9）：1185-1189.
[22] 陈照生.血清抗M型磷脂酶A2受体抗体、尿IgG4检测在特发性膜性肾病诊断中的应用价值[J].中国当代医药，2020，27（21）：148-151，253.
[23] 张婕，何伟春.抗CD20单克隆抗体治疗特发性膜性肾病的研究进展[J].中国医药，2021，16（7）：1104-1107.
[24] 郑茜子，高碧霞，俞小娟，等.胸腺瘤相关性肾小球病12例临床及病理特点分析[J].中华肾脏病杂志，2018， 34（8）：587-591.