T1b期肾癌及癌旁组织中PCNA、Bax的表达及意义

摘要

目的 探讨T1b期肾癌及癌旁组织中增殖细胞核抗原(PCNA)、Bax蛋白表达及意义,为T1b期肾癌行肾部分切除术中安全边距的选择提供理论依据.方法 选取21例行肾癌根治术的T1b期肾癌患者的癌组织标本,病理诊断均为肾透明细胞癌；分别取其癌组织(A组),癌旁0.2 cm(B组)、0.5 cm(C组)、1.0 cm(D组)处的正常肾组织,采用免疫组织化学染色法检测各组不同组织中的PCNA、Bax蛋白表达情况.结果 A组PCNA阳性表达率最高,明显高于其他各组(P均＜0.05)；A组Bax蛋白阳性表达率最低,明显低于其他各组(P均＜0.05).C、D组的PCNA蛋白阳性表达率明显低于B组,Bax蛋白阳性表达率明显高于B组(P均＜0.05).结论 癌旁0.5 cm是T1b期肾癌肾部分切除术的安全切除边距.%Objective To investigate the expressions of proliferating cell nuclear antigen (PCNA) and Bax protein in T1b renal cell carcinoma and adjacent tissues,and to provide a theoretical basis for the safety margins in partial nephrectomy.Methods In this study,there were 21 patients of T1b renal cell carcinoma undergoing radical nephrectomy,and their pathological diagnosis were all renal clear cell carcinoma.Then the cancer tissues (group A),the distance of adjacent tissues 0.2 cm (group B),0.5 cm (group C),1.0 cm (group D) were taken and the expressions of PCNA and Bax protein in different groups were detected by immunohistochemical staining.Results The positive expression rate of PCNA in group A was significantly higher than any other groups of adjacent tissues (A/B,A/C,A/D,P ＜ 0.05).The positive expression rate of Bax protein in group A was the lowest,which was significantly lower than any other groups of adjacent tissues (A/B,A/C,A/D,P ＜0.05).The positive expression rates of PCNA in group C and D were obviously lower than group B (all P ＜ 0.05) whereas the positive expression rates of Bax protein were obviously higher than group B (all P ＜ 0.05).Conclusion The safety margin in partial nephrectomy for the T1b stage of renal cell carcinoma is at least 0.5 cm of normal parenchyma tissue beyond the pseudocapsule of the tumor.