Critical evaluation of cancer risks in glomerular disease

Zaw Thet; Alfred K Lam; Dwarakanathan Ranganathan; Soe Yu Aung; Thin Han; Tien K Khoo

doi:10.1016/j.tranon.2022.101376

Critical evaluation of cancer risks in glomerular disease

Transl Oncol. 2022 May:19:101376. doi: 10.1016/j.tranon.2022.101376. Epub 2022 Feb 24.

Authors

Zaw Thet¹, Alfred K Lam², Dwarakanathan Ranganathan³, Soe Yu Aung⁴, Thin Han⁵, Tien K Khoo⁶

Affiliations

¹ School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Department of Nephrology, Central Queensland Hospital and Health Services, Rockampton, Queensland 4700, Australia.
² School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland 4006, Australia; Pathology Queensland, Gold Coast University Hospital, Southport, Queensland 4215, Australia. Electronic address: a.lam@griffith.edu.au.
³ School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Department of Nephrology, Metro North Hospital and Health Services, Herston, Queensland 4006, Australia.
⁴ Faculty of Medicine, University of Queensland, Herston, Queensland 4006, Australia; Department of Oncology, Central Queensland Hospital and Health Services, Rockhampton, Queensland 4700, Australia.
⁵ Department of Nephrology, Central Queensland Hospital and Health Services, Rockampton, Queensland 4700, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland 4006, Australia.
⁶ School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; School of Medicine, University of Wollongong, Keiraville, New South Wales 2522, Australia. Electronic address: t.khoo@griffith.edu.au.

Abstract

The increased cancer incidence in patients with glomerular disease can be secondary to an intrinsic immune dysfunction associated with the disease or/and extrinsic factors, especially immunosuppressants. The treatment for paraneoplastic glomerulopathy is different from primary glomerular disease. Immunosuppressive therapy often used for primary glomerulopathy may aggravate concomitant cancers in patients with paraneoplastic glomerulopathy. In membranous nephropathy (MN), measurement of serum circulating autoantibodies against podocyte transmembrane glycoprotein M-type phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain-containing 7A (THSD7A), immunohistochemical staining of kidney tissue for glomerular PLA2R, THSD7A, neural epidermal growth factor-like 1 protein (NELL-1) and specific types of immunoglobulin G (IgG) may be useful adjuncts when screening for underlying malignancies. This review addresses overall cancer risks in individuals with glomerular diseases and employment of biomarkers available for MN. We propose a scheme of screening of cancers frequently reported in the setting of glomerular disease.

Keywords: Cancers; Glomerular disease; Glomerulonephritis; Malignancy; Nephrotic syndrome.

Publication types

Review