Morphologic evidence that analgesic-induced kidney pathology contributes to the progression of tumors of the renal pelvis
| Autor: | J H, Stewart, J B, Hobbs, M R, McCredie |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Questionnaires Risk Carcinoma Squamous Cell analysis etiology Etiology - Endogenous Factors in the Origin and Cause of Cancer methods Surveys and Questionnaires Tobacco Odds Ratio Humans Kidney Pelvis Single-Blind Method Neoplasm Staging Aged Analgesics Non-Narcotic Wales Dose-Response Relationship Drug Smoking Age Factors Australia Phenacetin Calcinosis Analgesics Non-Narcotic Middle Aged Kidney Neoplasms drug effects Case-Control Studies Multivariate Analysis Carcinoma Squamous Cell adverse effects chemically induced Disease Progression Dose-Response Relationship Drug Female pathology history New South Wales New Zealand |
| Popis: | BACKGROUND: Whether phenacetin-containing analgesics cause renal pelvic tumors by virtue of the weak mutagenicity of phenacetin, or indirectly through local effects of analgesic-induced renal papillary scarring, is debated. Because phenacetin consumption ceased in New South Wales, Australia in 1975, cases of renal pelvic carcinoma seen 14-15 years later (many of which were associated with long-standing analgesic-induced renal papillary pathology) provided an opportunity to examine the temporal relation between phenacetin exposure and those histologic characteristics of the tumors and adjacent renal tissue that may implicate analgesics in their etiology. METHODS: The authors conducted a 'blinded' histopathologic review of tumors of the renal pelvis and adjacent noncancerous renal tissue from 100 cases for which epidemiologic data regarding risk factor exposure (specifically phenacetin-containing analgesics, tobacco, infection, and kidney stones) had been obtained in a population-based case-control study from New South Wales in 1989 and 1990. RESULTS: A history of consumption of phenacetin-containing analgesics was associated strongly with the presence and severity of diffuse renal papillary scarring, and less strongly with papillary calcification. The histologic grade of the renal pelvic tumors tended to rise significantly with consumption of phenacetin-containing analgesics in a dose-dependent fashion and with the degree of papillary scarring, but was not related to smoking. In multivariate analysis it was the degree of papillary scarring (to a greater extent than the amount of phenacetin consumption) that was associated significantly and strongly with a higher histologic grade. Only diffuse papillary calcification was associated significantly with squamous change in the renal pelvic tumors. CONCLUSIONS: Based on the results of the current study, the authors conclude that 1) in phenacetin-related tumors of the renal pelvis, the presence and severity of analgesic-induced renal papillary scarring correlates with tumor progression and 2) papillary calcification is a risk factor for squamous change in renal pelvic urothelioma |
| Databáze: | OpenAIRE |
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