Prevalence and prognosis of malignancy in THSD7A-associated membranous nephropathy: a systematic literature review and clinical case study

• Published in: Renal failure 2024-12, Vol.46 (1), p.2355353-2355353
• Main Authors: Xu, Qianqian, Li, Jiayi, Yang, Yue, Zhuo, Li, Gao, Hongmei, Jiang, Shimin, Li, Wenge
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adult; Aged; anti-phospholipase A2 receptor antibody; Biopsy; Female; Glomerulonephritis and Immunologic Disorders; Glomerulonephritis, Membranous - diagnosis; Glomerulonephritis, Membranous - epidemiology; Glomerulonephritis, Membranous - immunology; Glomerulonephritis, Membranous - pathology; Humans; Kidney - pathology; Kidneys; Literature reviews; Lung cancer; Male; Malignancy; Membranous nephropathy; Metastases; Middle Aged; Neoplasms - epidemiology; Nephropathy; Patients; Prevalence; Prognosis; Retrospective Studies; Small cell lung carcinoma; Systematic review; Thrombospondin; thrombospondin type-1 domain-containing 7A; Thrombospondins - immunology
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2024.2355353

This study aims to investigate the incidence and prognosis of malignancy in individuals with thrombospondin type-1 domain-containing 7A (THSD7A)-associated membranous nephropathy (MN). First, we performed a systematic literature review of prevalence of malignancy in THSD7A-associated MN. Then, we conducted a retrospective analysis of 454 patients diagnosed with MN through renal biopsy at our hospital between January 2016 and December 2020. We assessed the presence of serum anti-THSD7A antibodies and performed immunohistochemical staining of renal tissue for THSD7A. Subsequently, we followed patients with THSD7A-associated MN for a minimum of 3-5 years, collecting their clinical, pathological characteristics, and prognosis. Additionally, we conducted a literature review on patients with THSD7A-associated MN in conjunction with malignancy. We identified a total of nine articles containing comprehensive data on THSD7A-associated MN and malignancy. Among 235 patients with THSD7A-positive MN, 36 individuals had concurrent malignancies, resulting in a malignancy prevalence of 13.3% (95% CI: 8.9-17.7%). In our center, we followed up with 15 patients diagnosed with THSD7A-associated MN and observed three cases of concomitant tumors: two cases of lung adenocarcinoma and one case of small cell lung cancer with multiple metastases. The prevalence of malignancy in our cohort was 20%. Notably, we detected positive THSD7A staining in both renal and lung cancer tissues in one patient with small cell lung cancer. Patients with THSD7A-associated MN should undergo vigilant follow-up assessments, with a particular focus on actively seeking potential tumorigenic lesions to prevent misdiagnosis or oversight.