载脂蛋白 A-Ⅰ在8种不同组织学分型肾肿瘤中的表达

摘要

Objective:To investigate the expression of apolipoprotein A-Ⅰ( ApoA-Ⅰ) in eight histo-logical types of renal neoplasms and to explore a new biomarker for differential diagnosis .Methods:The immunochemistry was used to detect the expression of ApoA-Ⅰ in 23 cases of renal tumors , including clear cell carcinoma , papillary cell carcinoma , chromophobe cell carcinoma , oncocytoma , multilocular cystic carcinoma , renal pelvis invasive urothelial carcinoma , metanephric adenoma and collecting ducts carcinoma.Five cases of cancer-adjacent normal tissues were obtained from another five renal tumor pa-tients and were chosen as control group .Results: In the 23 cases of renal tumors , ApoA-Ⅰ was ex-pressed in 21 cases(positive rate was 91.3%).There were only two in five cases of normal tissues which expressed this protein ( positive rate was 40 .0%) .A significant differentiation was observed between the two groups(Z=-2.829,P=0.003).In renal clear cell carcinoma(RCC), ApoA-Ⅰ expression level was correlated with the grade and stage of tumor tissues .ApoA-Ⅰ was stained much more stronger in RCCⅡ-Ⅲ than in RCCⅠ( Z=-2.070,P=0.038).In various histological types of renal cancer , ApoA-Ⅰwas all expressed to some degrees .Conclusion:ApoA-Ⅰcan be chosen as a tumor biomarker to differentiate various histological types of renal neoplasms .%目的：研究载脂蛋白A-Ⅰ（ apolipoprotein A-Ⅰ，ApoA-Ⅰ）在8种不同组织学分型的肾肿瘤组织中的表达情况，探索用于鉴别诊断的新型肿瘤标志物。方法：应用免疫组织化学方法检测23例肾肿瘤（包括透明细胞癌11例、乳头状细胞癌1例、嫌色细胞癌3例、嗜酸细胞腺癌1例、多房性囊性细胞癌2例、肾盂尿路移行上皮癌3例、后肾腺癌1例、集合管癌1例）及5例癌旁正常组织中ApoA-Ⅰ的表达，癌旁正常组织取自除外23例肾癌组织的其他5例肾肿瘤的切缘外非癌组织。结果：23例肾肿瘤中，ApoA-Ⅰ阳性21例（阳性率91．3％）；肾癌旁组织5例，阳性2例（阳性率40．0％），ApoA-Ⅰ在肿瘤组织与癌旁正常组织中的表达差异有统计学意义（Z＝－2．829，P＝0．003）。比较不同组织学分型的肾肿瘤，11例肾透明细胞癌中，阳性9例（阳性率81．8％）， ApoA-Ⅰ的表达程度与肿瘤细胞的恶性程度有关，透明细胞癌Ⅱ级、Ⅲ级的表达程度明显高于Ⅰ级，差异有统计学意义（Z＝－2．070，P＝0．038）；乳头状细胞癌、嫌色细胞癌、嗜酸细胞腺癌、多房性囊性细胞癌、肾盂尿路移行上皮癌、后肾腺癌、集合管癌均有不同程度的阳性着色。结论：ApoA-Ⅰ在肾肿瘤组织中的表达特异升高，可作为区分不同组织学分型肾肿瘤的免疫组织化学标志物。