PDF(Pubmed)
Abstract：
BACKGROUND: Nephrotic syndrome (NS) can occur as a paraneoplastic disorder in association with various types of carcinoma. However, paraneoplastic nephrotic syndrome (PNS) is often misdiagnosed as idiopathic nephrotic syndrome or as an adverse effect of oncology treatment, leading to delayed diagnosis and suboptimal treatment. The characteristics of NS associated with solid malignancies are not yet elucidated. We systematically summarized the clinical data for 128 cases of NS combined with solid malignancies with the aim of informing the clinical management of PNS.
METHODS: We searched the PubMed database for articles published from the date of inception through to October 2023 using the following keywords: \"cancer\" or \"malignant neoplasms\" or \"neoplasia\" or \"tumors\" and \"nephrotic syndrome\", \"nephrotic\" or \"syndrome, nephrotic\". All data were extracted from case reports and case series, and the extraction included a method for identifying individual-level patient data.
RESULTS: A literature search yielded 105 cases of PNS and 23 of NS induced by cancer therapy. The median age at diagnosis was 60 years, with a male to female ratio of 1.8:1. In patients with PNS, manifestations of NS occurred before, concomitantly with, or after diagnosis of the tumor (in 36%, 30%, and 34% of cases, respectively). Membranous nephropathy (49%) was the most prevalent renal pathology and found particularly in patients with lung, colorectal, or breast carcinoma. Regardless of whether treatment was for cancer alone or in combination with NS, the likelihood of remission was high.
CONCLUSIONS: The pathological type of NS may be associated with specific malignancies in patients with PNS. Prompt identification of PNS coupled with suitable therapeutic intervention has a significant impact on the outcome for patients.
METHODS: We searched the PubMed database for articles published from the date of inception through to October 2023 using the following keywords: \"cancer\" or \"malignant neoplasms\" or \"neoplasia\" or \"tumors\" and \"nephrotic syndrome\", \"nephrotic\" or \"syndrome, nephrotic\". All data were extracted from case reports and case series, and the extraction included a method for identifying individual-level patient data.
RESULTS: A literature search yielded 105 cases of PNS and 23 of NS induced by cancer therapy. The median age at diagnosis was 60 years, with a male to female ratio of 1.8:1. In patients with PNS, manifestations of NS occurred before, concomitantly with, or after diagnosis of the tumor (in 36%, 30%, and 34% of cases, respectively). Membranous nephropathy (49%) was the most prevalent renal pathology and found particularly in patients with lung, colorectal, or breast carcinoma. Regardless of whether treatment was for cancer alone or in combination with NS, the likelihood of remission was high.
CONCLUSIONS: The pathological type of NS may be associated with specific malignancies in patients with PNS. Prompt identification of PNS coupled with suitable therapeutic intervention has a significant impact on the outcome for patients.
摘要：
背景：肾病综合征（NS）可以作为与各种类型癌症相关的副肿瘤疾病发生。然而,副肿瘤肾病综合征（PNS）常被误诊为特发性肾病综合征或肿瘤治疗的不良反应，导致诊断延迟和治疗欠佳。与实体恶性肿瘤相关的NS的特征尚未阐明。我们系统总结了128例NS合并实体恶性肿瘤的临床资料，旨在告知PNS的临床处理。
方法：我们在PubMed数据库中搜索了从开始之日到2023年10月发表的文章，使用以下关键词：“癌症”或“恶性肿瘤”或“瘤形成”或“肿瘤”和“肾病综合征”，“肾病”或“综合征”，肾病\“。所有数据均来自病例报告和病例系列，并且提取包括用于识别个体水平的患者数据的方法。
结果：通过文献检索，发现了105例PNS和23例因癌症治疗引起的NS。诊断时的中位年龄为60岁，男女比例为1.8:1。在PNS患者中，以前发生过NS的表现，同时，或在诊断出肿瘤后（36%，30%,34%的病例,分别)。膜性肾病（49％）是最常见的肾脏病理，特别是在肺部患者中发现。结直肠,或者乳腺癌.不管是单独治疗还是与NS联合治疗，缓解的可能性很高.
结论：NS的病理类型可能与PNS患者的特定恶性肿瘤有关。PNS的迅速识别以及适当的治疗干预对患者的预后有重大影响。
方法：我们在PubMed数据库中搜索了从开始之日到2023年10月发表的文章，使用以下关键词：“癌症”或“恶性肿瘤”或“瘤形成”或“肿瘤”和“肾病综合征”，“肾病”或“综合征”，肾病\“。所有数据均来自病例报告和病例系列，并且提取包括用于识别个体水平的患者数据的方法。
结果：通过文献检索，发现了105例PNS和23例因癌症治疗引起的NS。诊断时的中位年龄为60岁，男女比例为1.8:1。在PNS患者中，以前发生过NS的表现，同时，或在诊断出肿瘤后（36%，30%,34%的病例,分别)。膜性肾病（49％）是最常见的肾脏病理，特别是在肺部患者中发现。结直肠,或者乳腺癌.不管是单独治疗还是与NS联合治疗，缓解的可能性很高.
结论：NS的病理类型可能与PNS患者的特定恶性肿瘤有关。PNS的迅速识别以及适当的治疗干预对患者的预后有重大影响。
