原发性肾病综合征患儿肾组织中pRb的表达及意义

Expression of pRb in renal tissue from the children with primary nephrotic syndrome

目的探讨肾病综合征患儿肾组织视网膜母细胞瘤基因的蛋白产物pRb的表达水平及其与肾脏固有细胞增生之间的关系。方法以39例原发性肾病综合征患儿肾活检石蜡包埋肾组织及6例肾肿瘤肾切除患儿的正常肾组织作为研究对象,用免疫组织化学方法检测了pRb在肾组织的表达水平,并与肾病综合征患儿的病理类型、肾组织病理学积分及肾组织中增殖细胞核抗原(PCNA)的表达水平进行比较。结果肾病综合征组肾小球内PCNA和pRb阳性细胞百分率、肾小管-间质内的PCNA阳性细胞百分率均明显高于对照组,且不同病理类型肾病综合征患儿的肾小球内PCNA和pRb阳性细胞百分率存在显著差异。肾小球内PCNA和pRb的阳性细胞百分率分别与肾小球的病理积分呈正相关,肾小球内pRb的阳性细胞百分率和PCNA阳性细胞百分率呈正相关。结论肾病综合征患儿肾组织pRb表达水平增加促进了肾脏固有细胞的异常增生。

Objective To investigate the expression of retinoblastoma protein（pRb） in renal tissues from the children with primary nephrotic syndrome（NS）, and elucidate the relationship between pRb expression and renal cell proliferation. Methods Paraffin-embedded renal biopsy tissue sections from 39 patients with nephrotic syndrome were examined by immunohistoehemical staining with anti-pRb monoclonal antibody and anti- proliferating cell nuclear antigen（PCNA） monoclonal antibody. Normal renal tissue sections from 6 nephrectomized patients with nephroma were selected as control. Possible correlation between the percentage of PCNA, pRb positive cells and the pathologic type, histopathological score were evaluated separately. Possible correlation between the percentage of PCNA and pRb positive ceils were also evaluated. Results The percentage of PCNA positive cells（28.57 ±3.36 ）in glomeruli of nephrotic syndrome patients was significantly higher than t hat of t he control （ 10.76 ± 3.4 3 ） （ P 〈 0.05 ） ; The percentage of pRb positive cells （ 3 7.76 ± 4.4 5 ） in glomeruli of nephrotic syndrome patients was significantly higher than that of the control（7.96 ± 1.89）（P 〈 0. 001） ;The percentage of PCNA positive cells （68.32 ± 11.61 ）in tubulointerstitium of nephrotic syndrome patients was significantly higher than that of the control（ 12.55 ± 2.63） （ P 〈 0. 001）. The percentage of PCNA positive cells in glomeruli of minimal change disease, mesangialproliferative glomerulonephritis, membranoproliferative glomerulonephritis and focal and segmental glomeruloselerosis were（28.57 ± 3.36）, （40.25 ± 5.11）, （27.51 ± 3.61）, （34.55 ± 5.13） separately （ P 〈 0.05）, The percentage of pRh positive ceils in glomeruli of minimal change disease, mesangialproliferative glomerulonephritis, membranoproliferative glomerulonephritis and focal and segmental glomerulosclerosis were （32.86 ± 6.67）, （35.78 ± 7.49）, （39.82 ± 4.78）, （43.23 ± 6.11 ） separately（ P 〈 0.05）. The percentage of PCNA positive cells in glomeruli or tubulointerstitium of nephrotic syndrome patients was positively correlated with the histopathological score of glomeruli or tubulointerstitium separately, the correlation coefficient were 0. 748 2 （ P 〈 0. 001） and 0. 650 2 （ P 〈 0.01） ; The percentage of pRb positive cells in glomeruli of nephrotic syndrome patients was positively correlated with the histopathological score of glomeruli, the correlation coefficient was 0. 563 1 （ P 〈 0.05 ） ; The percentage of pRb positive cells in glomeruli of nephrotic syndrome patients was positively correlated with the percentage of PCNA positive cells in glomeruli, the correlation coefficient was 0. 550 1 （ P （ 0.05 ）. Conclusion The overexpression of pRb in renal tissues from the children with primary nephrotic syndrome enhance renal cell proliferation.