肾透明细胞癌中PTEN分子的表达与预后关系

目的探讨肾透明细胞癌肿瘤标本PTEN分子的表达水平，探讨其不同表达水平与各临床病理参数的关系，以及与患者预后生存的相关性。方法采用免疫组织化学法检测53例根治性肾切除术患者标本中PTEN分子的表达，分析其与临床病理参数及术后生存率的关系。结果肾透明细胞癌组织中，PTEN阳性表达患者的淋巴结转移率（31．0％）、远处器官转移率（13．8％）均低于PTEN阴性表达组患者（66．7％；45．8％），差异有统计学意义（P=0．01；P=0．01）。PTEN表达水平与病理分级、临床分期均呈负相关性（r=-0．473，P〈0．001；r=-0．332，P=O．015）。不同PTEN分子表达水平患者的性别、年龄等差异无统计学意义（P〉0．05；P〉0．05）：生存分析显示，PTEN阳性表达患者的总体生存率、无进展生存率均明显好于PTEN阴性表达患者（P〈0．001；P〈0．001）。结论肾透明细胞癌组织中PTEN分子表达水平与肿瘤分级、临床分期、远转移密切相关。PTEN分子的表达降低是肾癌恶性进展及预后不良的有效指标，可作为肾癌预后判断的标记物和免疫治疗靶分子。

Objective To investigate the PTEN expression in clear cell renal cell carcinoma （CCRCC） and its relations with clinicpathologic features and survivin of the patients.Methods： Expression of PTEN molecular in 53 patients with the clear cell renal cell carcinoma were detected by immunohistoehemieal stalning~ The relations of PTEN expression with the clinicopathologic parameters and survival of the patients were analyzed.Results： In CCRCC tissues, the rate of lymph node metastasis （31.0~/o） and distant organ metastasis （13.8%） in patients with positive expression of PTEN were lower than that of PTEN negative expression group of patients （66.7%; 45.8%）, respectively （P =0.01; P =0.01）. Levels of PTEN expression were negatively correlated with tumor grade and clinical stage （r = -0.473, P 〈 0.001; r = - 0.332, P = 0.015）. The PTEN expression were not related to gender, age （P〉0.05; P〉0.05）. Survival analysis demonstrated that the rates of overall survival and progression-free survival in subgroup of patients with PTEN positive expression were significantly better than that of patients with PTEN negative expression, respectively （P〈0.001; P〈0.001）.Conclusion： Level of PTEN expression was closely associated with tumor grade, clinical stage, metastasis. Low PTEN expression indicated the malignant progression and poor outcomes of CCRCC. PTEN molecular could be used as prognostic biomarker and immunotherapeutic target.