肾脏嗜酸性上皮性肿瘤中碳酸酐酶Ⅸ和Pax2的表达

Expression of CAⅨ and Pax2 in oncocytic renal epithelial tumors

目的探讨利用肾脏嗜酸性上皮性肿瘤碳酸酐酶Ⅸ(CAⅨ)和Pax2的表达差异,进行鉴别诊断的可行性。方法对90例肾脏嗜酸性上皮性肿瘤标本进行CAⅨ和Pax2免疫组化染色,观察两种抗体在肿瘤组织中的表达并分析其意义。结果 CAⅨ在嗜酸型嫌色性肾细胞癌(chromophobe renal cell carcinoma,ChRCC)(0/27)和肾嗜酸细胞腺瘤(renal oncocytoma,RO)(0/13)中均不表达。大部分嗜酸性透明细胞性肾细胞癌(clear cell renal cell carcinoma,CCRCC)(29/37)和2型乳头状肾细胞癌(papillary renal cell carcinoma,PRCC)(10/13)中CAⅨ阳性,CAⅨ在嗜酸性CCRCC中呈弥漫一致的胞膜强阳性,而在2型PRCC中为灶性或多灶性胞膜强阳性。Pax2在RO中100%阳性(13/13),而在嗜酸型ChRCC中几乎不表达(1/27),不同程度地表达于嗜酸性CCRCC(25/37)和2型PRCC(5/13)。结论 CAⅨ和Pax2组合可用于临床病理诊断中各型嗜酸性肾脏上皮性肿瘤的鉴别诊断。

Purpose To investigate whether Pax2 and CAⅨ could be used for the differential diagnosis of various types of oncocytic renal epithelial tumors in practice.Methods A total of 90 cases of oncocytic renal epithelial tumor were studied retrospectively.Immunohistochemical analysis of CAⅨ and Pax2 was performed on each subtype.Results CAⅨ was not expressed in both eosinophilic chromophobe renal cell carcinoma and oncocytoma.CAⅨ expression were detected in most of eosinophilic clear cell renal cell carcinoma cases with strong diffuse membrane immunostaining and in type 2 papillary renal cell carcinoma cases with focal to multifocal strong membrane immunostaining.All of the renal oncocytomas（100%） showed nuclear immunoreactivity to Pax2 in large proportions of tumor cells.The majority of chromophobe RCC were negative to Pax2.Pax2 nuclear reactivity was noted in parts of eosinophilic CCRCC and type 2 PRCC.Conclusion Combination of CAⅨ and Pax2 can be used for the differential diagnosis of various types of oncocytic renal epithelial tumors in practice.