SOCS-1、3在小儿先天性肾积水中的表达及其临床意义

SOCS-1、3 expression of congenital hydronephrosis in children and its' clinical significance

目的观察细胞因子信号转导抑制因子-1(SOCS-1)以及细胞因子信号转导抑制因子-3(SOCS-3)在先天性肾盂输尿管连接部梗阻(UPJO)导致的肾积水中的表达情况,探讨两者对肾脏损害程度的关系。方法 79例肾积水病例全部来自2006~2012年遵义医学院附属医院小儿外科先天性肾盂输尿管连接部梗阻(UPJO)的患者。最小27 d,最大14岁;男57例,女22例;左侧51例,右侧28例;术前常规行核素肾动态显像检查、切取病肾组织送病理科行石蜡包埋,根据HE染色行病理分级(I^V级),并以此进行分组,所有病肾中的SOCS-1、3用免疫组化S-P法检测其表达变化,测定SOCS-1、3蛋白表达的平均光密度值,并与核素肾动态显像检查测定的肾小球滤过率(GFR)间采用Pearson相关分析以及与病理分级间采用Spearman秩相关分析。7例对照组肾组织来源于肾外伤的患儿。结果病例组内SOCS-1、3随病理分级的增加而递增,病例组内SOCS-1、3与病理分级正相关(r_1=0.722,P<0.001;r_2=0.577,P<0.001);病肾GFR随病理分级的增加而递减,病肾组织内SOCS-1、3与病肾GFR负相关(r_1=-0.579,P<0.001;r_2=-0.536,P<0.001)。结论 SOCS-1、3蛋白表达的升高提示其可能在先天性肾积水肾纤维化过程中发挥着重要的作用,与先天性肾积水的病理生理过程密切相关。

Objective The expression of cytokine signaling-1（SOCS-1） and suppressor of cytokine signaling-3（SOCS-3） in hydronephrosis at congenital ureteropelvic junction obstruction（UPJO） was examined,and the relationship of renal damage degree between SOCS-1 and SOCS-3 was analyzed.Methods 79 hydronephrosis patients who came from Affiliated Hospital between 2006 and 2012 due to UPJO were analyzed.The youngest patient was 27 days old and the oldest one is 14 years old;57 cases were boys,22 cases girls;51 cases belonged to the left side and 28 cases the right;The preoperative routine radionuclide renal dynamic imaging was performed,and the diseased renal tissues were cut and sent to the pathology department for paraffin embedding and the pathological grading（I ～ V grades） according to HE straining.SOCS 1 and 3 within the sick kidneys were detected by immunohistochemical SP method and statistically analyzed.Pearson correlation analysis was adopted for glomerular filtration rate（GFR） detected by radionuclide renal dynamic imaging and Spearman rank correlation analysis was adopted between pathological grading.Control groups of 7 cases were from renal trauma children.Results Within the case group SOCS-1 and 3 increased progressively with the increase of pathological grading,within the case group SOCS-1 and 3 were positively correlated with pathological grading（r1= 0.722,P〈0.001;r2= 0.577,P〈0.001）;the diseased kidney GFR decreased progressively with the increase of pathological grading,and SOCS-1 and 3 were negatively correlated with diseased kidney GFR（r1=-0.579,P〈0.001;r2=-0.536,P〈0.001）.Conclusion The SOCS-1 and 3 expression pattern suggested it may play an important role in the process of tubulo-interstitial fibrosis in congenital hydronephrosis,and was closely related to the pathological physiological process of congenital hydronephrosis.