肾母细胞瘤血小板衍化内皮细胞生长因子mRNA的表达及其临床意义

Expression of platelet-derived endothelial cell growth factor mRNA in Nephroblastoma and its clinical significance

目的探讨小儿肾母细胞瘤中血小板衍化内皮细胞生长因子(PD-ECGF)mRNA的表达及其临床意义。方法用逆转录多聚酶链反应(RT-PCR)方法检测30例肾母细胞瘤组织、8例瘤旁、4例无瘤肾组织的PD-ECGF mRNA的表达情况,并分析PD-ECGF mRNA的表达与肾母细胞瘤的病理分型、临床分期、转移及预后之间的关系。结果所有标本均有不同程度的PD-ECGF mRNA的表达,表达程度呈肿瘤组织、瘤旁组织、无瘤组织依次降低。肿瘤组织是瘤旁组织的1．22倍(t= 0．855,P>0．05);瘤旁组织是无瘤对照组的2．07倍(t=2．65,P<0．05);肿瘤组织是无瘤对照组的2．53倍(t=2．05,P<0．05)。在肾母细胞瘤组织中PD-ECGF mRNA的表达与病理分型无关(F= 0．691,P>0．05),与临床分期也无关(F=0．05,P>0．05),但有转移者的PD-ECGF mRNA的表达高于无转移者。全部病例获得随访,平均随访50．2个月(17-75个月),术中已发现转移和术后转移复发共18例,死亡7例。所有转移、复发患儿的PD-ECGF mRNA水平是无转移、复发患儿的1．72倍(t=2．2766,P<0．05);是无瘤对照组的2．9倍(t=2．608,P<0．05)。用PD-ECGF mRNA的表达预测肾母细胞瘤转移、复发及死亡的敏感性为83．3％,特异性80．0％。结论PD-ECGF mRNA在肾母细胞瘤组织中呈高表达,与其预后密切相关。提示PD-ECGF mRNA的表达对判断肾母细胞瘤预后有一定的意义。

Objective To investigate the mRNA expression of platelet-derived endothelial cell growth factor （PD-ECGF） in Nephroblastoma and its＇ clinical significance. Methods PD-ECGF mRNA expression were determined by RT-PCR in 30 cases of nephroblastoma tissues and 8 cases of paracancer renal tissues and 4 cases of renal tissue without tumour. The relations about PD-ECGF mRNA expression were also analyzed in nephrohlastoma＇s different clinical stage and different pathology type and metastasis and prognosis. Results Some degree of PD-ECGF mRNA expression was present in all samples. The PD-ECGF mRNA level was 1.22-fold higher in tumour tissues than in paracancer renal tissues（t = 0. 855, P〉0. 05） and 2. 53-fold higher than in renal tissue without tumour （t = 2. 05, P〈 0. 05） . Paracancer renal tissues expressed 2. 07-fold higher PD-ECGF mRNA level than renal tissue without tumour（t= 2. 65,P〈0. 05）. We also educe that PD-ECGF mRNA level do not correlate with pathology type（F= 0. 691 ,P〉0. 05）, clinical stage（F = 0. 05, P〉0. 05） in nephroblastoma. The most important result we get is that the PD-ECGF mRNA level in nephroblastoma with metastasis is 1.72- fold higher than the tumour without metastasis（t = 2. 2766,P〈0. 05）and is 2. 9-fold higher than the comparision without tumour （t = 2. 608, P 〈 0.05）. The sensitivity and specificity for predicting tumour recurrence were 83. 3% and 80. 0% respectively if use 0. 99 as a cutoff value of PD-ECGF mRNA level in this group of nephroblastoma. Conclusions There were over expression of PD-ECGF mRNA in nephroblastoma and the PD-ECGF mRNA level correlates with the tumour＇s metastasis and recurrence. To analyze the PD-ECGF mRNA level might contribute to the evaluation of nephroblastoma＇s prognosis.