肾移植受者移植肾中肾细胞癌的临床特征:系统性范围界定综述。

Q3 Medicine Baylor University Medical Center Proceedings Pub Date : 2024-07-16 eCollection Date: 2024-01-01 DOI:10.1080/08998280.2024.2375705
Manasawee Tanariyakul, Sakditad Saowapa, Noppawit Aiumtrakul, Chalothorn Wannaphut, Natchaya Polpichai, Pharit Siladech
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引用次数: 0

摘要

背景:肾移植受者对肾细胞癌(RCC)的易感性大大增加,尤其是原肾与异体肾:在这项系统性的范围界定综述中,对 MEDLINE 和 EMBASE 数据库进行了详尽的检索。收集了与异体肾RCC相关的临床表现、供体人口统计学、诊断间隔、肿瘤大小、组织病理学特征和治疗结果等信息:结果:搜索结果包括42篇病例报告和11篇回顾性队列研究,共涉及274名患者。大多数病例(75.4%)在临床上处于潜伏期,主要通过影像学检查发现。症状表现包括血尿、血清肌酐水平升高、腹部不适和移植物相关疼痛等。据计算,肾移植与 RCC 诊断之间的平均时间间隔为 11.6 年,但两者之间存在相当大的差异。值得注意的是,乳头状和透明细胞 RCC 是最常见的组织病理学亚型。然而,纵向随访数据的缺乏是一个值得注意的问题:这项调查强调,由于无症状RCC的发病率很高,因此移植后必须进行严格的监测。未来的研究应重点关注筛查方法的临床结果和成本效益,以制定预防策略。
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Clinical characteristics of renal cell carcinoma in the transplanted kidney in renal transplant recipients: a systematic scoping review.

Background: Renal transplant recipients confront a substantially elevated susceptibility to renal cell carcinoma (RCC), particularly in their native kidneys as opposed to allografts.

Methods: In this systematic scoping review, exhaustive searches were conducted of the MEDLINE and EMBASE databases. Information was gathered on clinical manifestations, donor demographics, diagnostic intervals, tumor dimensions, histopathological characteristics, and therapeutic outcomes associated with RCC arising in allograft kidneys.

Results: The searches yielded a corpus of 42 case reports and 11 retrospective cohorts, encompassing a cohort of 274 patients. The majority of cases (75.4%) were clinically latent, discerned primarily through imaging modalities. Symptomatic presentations encompassed manifestations such as hematuria, elevated serum creatinine levels, abdominal discomfort, and graft-related pain. The mean temporal interval between renal transplantation and RCC diagnosis was calculated at 11.6 years, albeit displaying considerable variance. Notably, papillary and clear cell RCC emerged as the prevailing histopathological subtypes. However, the paucity of longitudinal follow-up data represents a notable caveat.

Conclusion: This investigation underscores the imperative of rigorous posttransplant surveillance regimes owing to the substantial prevalence of asymptomatic RCC instances. Future research should focus on clinical outcomes and cost-effectiveness of screening practices to develop preventive strategies.

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