A follow-up analysis of positron emission tomography/computed tomography in detecting hidden malignancies at the time of diagnosis of membranous nephropathy

// Zhonglin Feng 1 , Shuxia Wang 2 , Yanlin Huang 3 , Xinling Liang 1 , Wei Shi 1 and Bin Zhang 1 1 Department of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China 2 Department of Nuclear Medicine and PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China 3 Medical Genetics Center of Guangdong Women and Children Hospital, Guangzhou, China Correspondence to: Bin Zhang, email: // Wei Shi, email: // Keywords : membranous nephropathy, malignancy, PET/CT, Pathology Section Received : September 05, 2015 Accepted : February 05, 2016 Published : February 19, 2016 Abstract Membranous nephropathy (MN) is the most common kidney disease reported in a variety of malignant diseases. Search for an occult malignancy in MN has presented special challenges. 124 MN patients with a physical examination not suspicious for cancer underwent screening for an occult malignancy with either 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scanning ( n = 49) or conventional screening ( n = 75) at the time of diagnosis of MN, and were followed up (median,28 months). 154 patients who refused to undergo any screening were followed up (median, 30 months). In FDG-PET/CT cohort, 5 (10.20%) patients were screened and confirmed as malignancy, in contrast, 1 (1.33%) patient in conventional screening cohort. During follow-up, none of malignancy was detected in FDG-PET/CT cohort, 3(4.05%) patients in conventional screening cohort, and 8(5.19%) patients in no-screening cohort. All 6 cases of cancer were detected at early stages and underwent curative resection, and after the resection, proteinuria decreased. In contrast, 11 cases of cancer detected during follow-up died without any remission of proteinuria. These preliminary data provide the first evidence for a potential cancer surveillance that the malignancy screening either through conventional or by PET-CT at the diagnosis of MN led to an early diagnosis and curative treatment.