G250、Ki-67和Bax在肾细胞癌组织中的表达与术后生存率的关系

The expression of G250、Ki-67 and Bax in renal cell carcinoma and their clinical implications of free survival after operations

目的检测G250/MN/CA(简称G250)、Ki-67和Bax在肾细胞癌及癌旁组织中的表达,探讨G250在肿瘤发展过程中的作用,以及G250、Ki-67和Bax表达对肾细胞癌患者术后生存率的影响。方法采用免疫组化SP法检测54例肾癌组织和18例癌旁组织中G250、Ki-67和Bax的表达。结果G250、Ki-67和Bax免疫染色位于肾癌细胞的细胞膜、细胞核和细胞质,三者在肾细胞癌与癌旁组织中的阳性表达差异均有统计学意义;Ki-67和Bax在肾细胞癌不同病理分级和临床分期中的阳性表达差异有统计学意义,而G250的阳性表达差异无统计学意义。随访的47例患者中,G250阳性组患者术后远期无瘤生存率低于G250阴性组,但二者间的差异无统计学意义;进一步研究表明G250阳性高表达的患者术后无瘤生存率明显高于低表达者,经Log-rank检验差异有统计学意义。Ki-67阳性组患者术后远期无瘤生存率低于Ki-67阴性组,二者间的差异无统计学意义。Bax阳性组患者术后远期无瘤生存率高于Bax阴性组,二者间的差异有统计学意义。结论G250作为一种新的肾细胞癌特异性标志物,在肾细胞癌尤其是肾透明细胞癌的诊断、筛选方面具有良好的前景,并可能影响患者的术后无瘤生存率,但其表达与肾细胞癌临床分期及病理分级无明显相关;肾细胞癌中Ki-67和Bax的表达与肾细胞癌临床分期及病理分级有明显相关性,后者的表达同时也会影响患者术后的无瘤生存率。联合检测肾细胞癌组织中G250、Ki-67和Bax的表达有利于早期诊断肾细胞癌,并有利于判断患者的预后情况,对临床工作有指导意义。

Objective To investigate the expression of G250/MN/CA（G250）,Ki-67 and Bax in renal cell carcinoma and the adjacent normal tissues,and to analyze the role of them playing in the biological behavior and survival after operations. Methods 54 renal cell carcinoma cases and 18 adjacent normal tissues were examined.The expression of G250,Ki-67 and Bax was examined in renal cell carcinoma cases and 18 adjacent normal tissues,using the monoclonal antibodies with SP immuno-histochemistry technique. Results The G250,Ki-67 and Bax immunostaining was seperately localized in the cytomembrane,cytoblast and cytoplasm of cancer cells.The frequency of G250 expression is much stronger than the adjacent normal tissues,but not corresponding with pathostage and clinical degree of differentiation.Analysis of survival data showed that the expression of G250 might have some effects on disease free survival,but in log-rank test it has no significant difference.However,Extensive G250 expression in renal cell carcinoma had better survival than cases with limited G250 expression.The frequency of Ki-67 expression was corresponding with pathostage and clinical degree of differentiation.Analysis of survival data showed that the expression of Ki-67 in log-rank test has no significant difference.The expression of Bax in cytoplasm was decreased in renal cell carcinoma and was correlated with stage and grade of tumor.The positive expression of Bax had better survival than cases with negative Bax expression. Conclusions G250 maybe a good tumor specific marker in renal cell carcinoma,especially in clear renal cell carcinoma and plays an important role in diagnosis and screening of renal cell carcinoma.The expression of Ki-67 and Bax in renal cell carcinoma are correlated with pathostage and differential grade and the later has an effect on disease free survival.The expression of G250,Ki-67 and Bax in renal cell carcinoma are helpful for clinicians to diagnose and to estimate prognosis of the patients after operations.