实体肿瘤相关的副肿瘤性肾小球病：综述

摘要(中文译文)

早在20世纪20年代，人们就已认识到恶性肿瘤可伴发肾小球疾病。此后，多种肿瘤被发现与广泛的肾小球病变相关，包括肺癌、胃肠道癌等实体瘤以及血液系统恶性肿瘤。这些观察结果共同提示，肾小球病变与恶性肿瘤之间可能存在潜在的病理生理联系。然而，肿瘤如何触发肾小球损伤在很大程度上仍不清楚。本综述总结了目前关于实体瘤患者副肿瘤性肾小球疾病的认识，重点介绍流行病学、病理生理学、诊断生物标志物、临床特征及治疗方法方面的最新进展。此外，我们提出了一个机制框架，将多种组织学模式归纳为四条主要致病途径：免疫复合物及抗体介导的沉积、T细胞及细胞因子介导的足细胞病、生长因子诱导的肾小球高通透性，以及前体蛋白沉积。该分类为管理这一被低估的疾病提供了概念上的清晰性和临床实用性。

Abstract

The recognition that malignancies may be accompanied by glomerular disease dates back to the 1920s. Various neoplasms have since been linked to a broad spectrum of glomerular lesions. These include solid tumors, such as lung and gastrointestinal tract cancers, as well as hematologic malignancies. Together, these observations suggest underlying pathophysiologic connections between the glomerulopathy and malignancy. However, how neoplasms trigger glomerular injury is still largely unclear. This review summarizes current knowledge of paraneoplastic glomerular diseases in patients with solid tumors, focusing on recent advances in epidemiology, pathophysiology, diagnostic biomarkers, clinical features, and therapeutic approaches. Furthermore, we propose a mechanistic framework that organizes the diverse histological patterns into four major pathogenic pathways: immune complex and antibody-mediated deposition, T-cell and cytokine-mediated podocytopathy, growth factor-induced glomerular hyperpermeability, and precursor protein deposition. This classification provides both conceptual clarity and clinical utility for managing this underrecognized condition.

如何引用

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