血小板衍化内皮细胞生长因子在肾细胞癌中的表达及其预后意义

Expression and clinical significance of thymidine phosphorylase/platelet-derived endothelial cell growth factor in renal cell carcinoma

目的探讨血小板衍化内皮细胞生长因子（PD—ECGF）在。肾细胞癌中的表达及其预后意义。方法采用免疫组化EnVision两步法检测2002年6月至2006年12月76例肾细胞癌患者肿瘤组织中PD—ECGF的表达水平，并分析其与肾细胞癌患者临床病理特征及预后的关系。结果76例肾癌患者肿瘤组织中PD—ECGF高表达41例，低表达35例。PD—ECGF表达水平与肿瘤分期及组织学分级呈正相关。PD—ECGF高表达患者5年总生存率（60．98％）显著低于PD．ECFG低表达患者（94．29％，P=0．000）。单因素分析显示肿瘤分期、淋巴结转移、远处转移、组织学分级及PD．ECGF表达水平均与肾癌患者5年生存率密切相关，Cox比例风险模型多因素分析显示肿瘤分期、组织学分级及PD—ECGF表达水平为影响肾癌患者预后的独立危险因素（OR=17．971、9．702、6．790，95％CI：3．010～107．290、1．835～51．305、1．156—39．894）。结论PD-ECGF在肾细胞癌的发生、发展中可能起重要作用，PD-ECGF高表达可能与肾细胞癌的预后有关。

Objective To explore the expression and clinical significance of thymidine phosphorylase/platelet-derived endothelial cell growth factor （PD-ECGF） in renal cell carcinoma. Methods The expression of PD-ECGF in 76 specimens of renal cell carcinoma from June 2002 to December 2006 was examined by EnVision immunohistoehemistry. The correlation of the expression of PD-ECGF with the clinicopathological characteristics and prognosis in renal cell carcinoma patients were analyzed. Results Among 76 renal cell carcinoma patients, 41 patients had a high-level expression of PD-ECGF while another 35 patients a low-level expression. The expression of PD-ECGF was positively correlated with tumor stage and histological grade. The 5-year overall survival rate was significant lower in the patients with a high-level expression of PD-ECGF （ 60. 98% vs 94. 29% , P = 0. 000 ） . Univariate analysis showed that the characteristics with the prognostic significance for survival were tumor stage, lymph node metastasis, distant metastasis, histological grade and the expression of PD-ECGF. Multivariate analysis showed that tumor stage, histological grade and the expression of PD-ECGF were independent prognostic factors（ OR： 17.971, 9. 702,6. 790,95% CI：3. 010 - 107. 290,1. 835 - 51. 305,1. 156 - 39. 894）. Conclusion The expression of PD-ECGF may play an important role in the development and invasion of renal cell carcinoma. An elevated level of PD-ECGF is probably correlated with the prognosis of renal cell carcinoma.