儿童原发性肾病综合征肾脏C-myc表达的意义

Significance of C-myc Expression in Renal Tissue in Children's Primary Nephrotic Syndrome

目的观察C-myc在儿童原发性肾病综合征不同肾脏病理的表达以及与肾病理损害的相关性,说明C-myc再表达在儿童原发性肾病综合征的作用。方法采用免疫组化法分析C-myc在30例原发性肾病综合征不同病理的表达,并与肾病理积分作相关性分析。结果⑴所有肾病理切片均存在不同程度C-myc阳性显色,正常对照组无阳性表达。肾小球区主要在足细胞表达,个别内皮细胞有表达;肾小管区表达较为强烈,主要部位在近端肾小管,远端肾小管表达较少,集合管及肾小管间质、血管部位未见阳性表达。⑵不同肾脏病理类型间C-myc表达在足细胞和远端肾小管部位差异不明显,近端肾小管的表达FSGS与MsPGN、MCD比较均明显减少(P<0.05)。⑶C-myc表达与肾小球和肾小管病理积分均呈负相关(P<0.05)。结论C-myc再表达参与了儿童原发性肾病综合征的病理发生,可能与损伤上皮细胞的增殖与再生有关。

Objective To observe the correlation between the C-mye expression and pathologic lesions of kidney to explore the role of C-myc re-expression in children＇s primary nephrotic syndrome（CPNS）. Methods The C-myc expression of renal tissue in 30 cases of CPNS was detected using immunohistochemical method, and the correlation between C-myc expression and renal pathological lesions was analyzed. Results There were. various degrees of C-myc positive staining in the renal tissue of all patients with CPNS, while no C-myc positive expression in the renal tissue of control group. C-myc expression was mainly located in podocytes and less in endothelial cells of glomeruli. There was high level of C-myc expression in nephric tubules, especially in proximate tubules. There was no C-myc expression in the Henle＇s loop, tubnlous matrix and vessel areas. There was no obvious difference in C-myc expression level in the podocytes and proximate tubules among the different pathological types of CPNS. The level of focal segmental glomerulosclerosis（FSGS） in proximate tubules obviously reduced compared with mesangil proliferative glomerulonephritis（MsPGN） and minimal change disease（MCD） （P〈0.05）. C-myc expression level was positively correlated with the severity of neral pathological lesions. Conclusion C-myc re-expression was involved in the pathogenesis of children＇s primary nephrotic syndrome, and may be related with the proliferation and regeneration of the impaired epithelial cells.