肾透明细胞癌中血小板衍生生长因子BB和微血管密度的检测及临床意义

Detection and clinical significance of platelet derived growth factor-BB and microvessel density in clear cell renal cell carcinoma

目的探讨肾透明细胞癌中血小板衍生生长因子BB（PDGF-BB）的表达以及CD34标记的微血管密度（MVD）与患者临床病理特征及预后的关系。方法采用免疫组化sP法，检测CD34和PDGF—BB在100例肾透明细胞癌组织中的表达情况。结果100例肾透明细胞癌组织中，CD34标记的MVD为（105．49±37．95）个／高倍视野。以均数为分界点，将100例肾透明细胞癌分为低MVD组（42例）和高MVD组（58例）。低MVD组和高MVD组的MVD分别为（75．12±22．41）个／高倍视野和（135．86±22．91）个／高倍视野，差异有统计学意义（P〈0．001）。肾透明细胞癌的MVD与肿瘤的T分期、病理分级以及术后是否发生转移有关（均P〈0．05）。PDGF-BB蛋白低表达38例，高表达62例。肾透明细胞癌中PDGF-BB蛋白的表达与肿瘤直径、T分期、病理分级以及术后是否发生转移有关（均P〈0．05）。生存分析结果显示，高MVD和PDGF—BB蛋白高表达的肾透明细胞癌患者的预后明显优于低MVD和PDGF．BB蛋白低表达者（均P〈0．001）。相关性分析结果显示，PDGF—BB蛋白在肾透明细胞癌中的表达与MVD呈正相关（r=0．461，P〈0．001）。结论在肾透明细胞癌中，MVD和PDGF—BB蛋白的表达越高，肿瘤的分级和分期越好，患者的生存时间越长。

Objective To investigate the expression of platelet derived growth factor-BB （PDGF- BB） and microvessel density （MVD） marked with CD34 in clear cell renal cell carcinoma （CCRCC） and explore their relevance to clinicopathologic features and prognoses of patients. Methods Expressions of PDGF-BB and CD34 in the tissue samples of 100 clear cell renal cell carcinomas were detected by immunohistochemical （IHC） SP staining. The microvessel density （MVD） was counted using Weidner＇s method. For PDGF-BB assessment, the staining intensity and the proportion of positive tumor cells were analyzed. Staining was considered immunoreactive when brown granules were identified in the cytoplasm or nuclei of tumor cells. Staining intensity and the proportion of positively stained tumor cells in lesions was scored for further analysis. Statistical analysis was performed using the software SPSS 18.0. Results The MVD value marked by CD34 in the 100 cancer tissues was （ 105.49 ±37.95 ） profiles/HPF. The median value of MVD in the entire cohort was used as the cut-off point for low MVD group （42 cases） and high MVD group （58 cases）. The MVD of the low and high MVD groups was （75.12 ±22.41） profiles/ HPF and （ 135.86 ± 22.91 ） profiles/HPF, respectively, with a statistically significant difference （P 〈 0.001 ）. MVD was significantly correlated with the tumor T staging, histopathological grading and postoperative metastasis in CCRCC （P 〈0.05, respectively）. Among the 100 CCRCC cases, there were 38 cases with low PDGF-BB expression and 62 cases with high PDGF-BB expression, and the expression of PDGF-BB was significantly correlated with tumor diameter, T staging, histopathological grading and postoperative metastasis in the CCRCC （ P 〈 0.05, respectively）. Kaplan-Meier survival analysis showed that the cancer specific survival（ CSS）in CCRCC patients with high expression of MVD and PDGF-BB was significantly better than that in the group with low MVD and low PDGF-BB expression （P 〈 0. 001, respectively）. Expression of PDGF-BB protein was positively associated with the MVD assessed by Spearman＇s correlation and factor analysis （r = 0. 461, P 〈 0. 001 ）. Conclusion Significantly increased MVD and PDGF-BB expression detected in CCRCC patients indicate a better tumor grading and staging, and a longer survival time.