不同肾癌亚型组织中c—kit与增殖细胞核抗原的表达及意义

Expression and clinical significance of c-kit and PCNA in renal cell carcinoma （RCC） subtypes

目的 探讨不同亚型肾癌组织中c-kit及增殖细胞核抗原（PCNA）的表达及临床意义.方法 采用免疫组化SP法测定137例透明细胞癌、82例乳头状癌、51例嫌色细胞癌标本中c-kit蛋白和PCNA的表达情况. 结果 嫌色细胞癌中c-kit强阳性表达率为94.1%（48/51）,明显高于透明细胞癌的16.1%（22/137）及乳头状癌的28.1%（23/82）,差异有统计学意义（P=0.001）.c-kit强阳性表达仅与嫌色细胞癌分期有关（P=0.038）;在透明细胞癌和乳头状癌中PCNA表达与分级关系密切（P=0.043,P=0.011）,而与嫌色细胞癌分级无关. 结论 嫌色细胞癌中c-kit表达率明显高于其他肾癌亚型,且与肿瘤局部进展关系密切.不同亚型间c-kit表达差异有助于肾癌的临床鉴别诊断和指导晚期肾癌靶向治疗药物的选择.

Objective To investigate the expression of c-kit and analyze its relationship with proliferating cell nuclear antigen （PCNA） in RCC subtypes and its clinical progression. Methods Expression of c-kit protein was retrospectively studied with immunohistochemistry in paraffin sections from 137 cases of clear renal cell carcinoma （CCRCC）, 82 papillary renal cell carcinoma （PRCC）, 51 chromophobe renal cell carcinoma （ChRCC）. Results The positive rate of c-kit in ChRCC was 94.1%（48/51）, it was statistically higher than that in CCRCC （16. 1%, 22/137） and PRCC （28.1 %, 23/82）（P=0. 001 ）. In ChRCC, the positive expression of c-kit was related with TNM stages. The positive expression of PCNA was related with the grade in CCRCC and PRCC. But there was no relationship between PCNA expression and grade of ChRCC. It also had the relationship with the metastasis in CCRCC. Conclusions The expression of c-kit in ChRCC is higher than in other subtype of RCC, and associated with tumor local progression. That makes c-kit as a helpful marker to discriminate different subtypes of kidney cancer.