Long-term risk of cancer in membranous nephropathy patients
Long-term risk of cancer in membranous nephropathy patients
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DOI：
10.1053/j.ajkd.2007.06.003
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发表时间：
2007-09-01
影响因子：
13.2
通讯作者：
Iversen, Bjarne M.
中科院分区：
文献类型：
--
作者：
Bjorneklett, Rune;Vikse, Bjorn Egil;Iversen, Bjarne M.
背景资料：众所周知，膜性肾病（MN）与癌症之间存在关联，MN患者通常在诊断时进行癌症检查。MN后癌症的长期风险还没有得到很好的研究。研究设计：挪威肾脏活检登记处和挪威癌症登记处之间记录联系的队列研究。设置和参与者：1988年至2003年的161例MN患者。预测因素：MN患者与年龄和性别调整的挪威普通人群的比较。结果：2003年报告的癌症诊断。结果：平均随访时间为6.2年（范围：0.1 - 15年）。33例患者发生癌症;包括24例在诊断MN后发生癌症的患者。从MN诊断到癌症诊断的中位时间为60个月（范围，0至157个月）。癌症的平均年发病率为2.4/100人-年（肾活检后0- 5年为2.1/100人-年，5 - 15年为2.8/100人-年）。在诊断MN后的0至15年期间，预期癌症数量为10.7，导致癌症的标准化发病率为2.25（95%置信区间为1.44至3.35）。在确诊后5 ~ 15年，标准化发病率为2.30（95%可信区间为1.19 ~ 4.02）。MINI患者发生癌症的年龄较大（65岁对52岁; P < 0.001）。患有癌症和MN的患者比没有癌症的患者有更高的死亡率（67%对26%; P < 0.001）。局限性：MN后的细胞毒性和免疫抑制药物的后续治疗是未知的。结论：MN诊断后，观察到癌症的风险增加，持续多年。
Background: There is a well-known association between membranous nephropathy (MN) and cancer, and patients with MN usually are examined for cancer at the time of diagnosis. The long-term risk of cancer after MN is not well studied.Study Design: Cohort study with record linkage between the Norwegian Kidney Eliopsy Registry and Norwegian Cancer Registry.Setting & Participants: 161 patients with MN from 1988 to 2003.Predictor: Patients with MN compared with the age- and sex-adjusted general Norwegian population.Outcomes: Cancer diagnosis reported through 2003.Results: Mean duration of follow-up was 6.2 years (range, 0.1 to 15 years). 33 patients developed cancer; including 24 patients with cancer after the diagnosis of MN. Median time from diagnosis of MN to diagnosis of cancer was 60 months (range, 0 to 157 months). Mean annual incidence ratio of cancer was 2.4/100 person-years (2.1/100 person-years in the 0- to 5-year period and 2.8/100 person-years for the 5 to 15 years after kidney biopsy). During the 0 to 15 years after the diagnosis of MN, the expected number of cancers was 10.7, resulting in a standardized incidence ratio of cancer of 2.25 (95% confidence interval, 1.44 to 3.35). In the 5 to 15 years after diagnosis, standardized incidence ratio was 2.30 (95% confidence interval, 1.19 to 4.02). Patients with MINI who developed cancer were older (65 versus 52 years; P < 0.001). Patients with cancer and MN had a greater mortality rate than patients without cancer (67% versus 26%; P < 0.001).Limitations: Follow-up treatment after MN with cytotoxic and immunosuppressive medications is not known.Conclusions: An increased risk of developing cancer is observed after the diagnosis of MN, which persists for many years.