载脂蛋白A-Ⅰ在8种不同组织学分型肾肿瘤中的表达

Expression of apolipoprotein A-Ⅰ in eight histological types of renal neoplasms

目的:研究载脂蛋白A-Ⅰ(apolipoprotein A-Ⅰ,Apo A-Ⅰ)在8种不同组织学分型的肾肿瘤组织中的表达情况,探索用于鉴别诊断的新型肿瘤标志物。方法:应用免疫组织化学方法检测23例肾肿瘤(包括透明细胞癌11例、乳头状细胞癌1例、嫌色细胞癌3例、嗜酸细胞腺癌1例、多房性囊性细胞癌2例、肾盂尿路移行上皮癌3例、后肾腺癌1例、集合管癌1例)及5例癌旁正常组织中Apo A-Ⅰ的表达,癌旁正常组织取自除外23例肾癌组织的其他5例肾肿瘤的切缘外非癌组织。结果:23例肾肿瘤中,Apo A-Ⅰ阳性21例(阳性率91.3%);肾癌旁组织5例,阳性2例(阳性率40.0%),Apo A-Ⅰ在肿瘤组织与癌旁正常组织中的表达差异有统计学意义(Z=-2.829,P=0.003)。比较不同组织学分型的肾肿瘤,11例肾透明细胞癌中,阳性9例(阳性率81.8%),Apo A-Ⅰ的表达程度与肿瘤细胞的恶性程度有关,透明细胞癌Ⅱ级、Ⅲ级的表达程度明显高于Ⅰ级,差异有统计学意义(Z=-2.070,P=0.038);乳头状细胞癌、嫌色细胞癌、嗜酸细胞腺癌、多房性囊性细胞癌、肾盂尿路移行上皮癌、后肾腺癌、集合管癌均有不同程度的阳性着色。结论:Apo A-Ⅰ在肾肿瘤组织中的表达特异升高,可作为区分不同组织学分型肾肿瘤的免疫组织化学标志物。

Objective： To investigate the expression of apolipoprotein A-Ⅰ（ Apo A-Ⅰ） in eight histological types of renal neoplasms and to explore a new biomarker for differential diagnosis. Methods： The immunochemistry was used to detect the expression of Apo A-Ⅰ in 23 cases of renal tumors,including clear cell carcinoma,papillary cell carcinoma,chromophobe cell carcinoma,oncocytoma,multilocular cystic carcinoma,renal pelvis invasive urothelial carcinoma,metanephric adenoma and collecting ducts carcinoma. Five cases of cancer-adjacent normal tissues were obtained from another five renal tumor patients and were chosen as control group. Results： In the 23 cases of renal tumors,Apo A-Ⅰ was expressed in 21 cases（ positive rate was 91. 3%）. There were only two in five cases of normal tissues which expressed this protein（ positive rate was 40. 0%）. A significant differentiation was observed between the two groups（ Z =- 2. 829,P = 0. 003）. In renal clear cell carcinoma（ RCC）,Apo A-Ⅰ expression level was correlated with the grade and stage of tumor tissues. Apo A-Ⅰ was stained much more stronger in RCCⅡ- Ⅲ than in RCC Ⅰ（ Z =- 2. 070,P = 0. 038）. In various histological types of renal cancer,Apo A-Ⅰ was all expressed to some degrees. Conclusion： Apo A-Ⅰ can be chosen as a tumor biomarker to differentiate various histological types of renal neoplasms.