CD71在IgA肾病肾组织中的表达与临床病理关系

Expression of CD71 and it relationship with clinicopathology in IgA nephropathy

目的研究CD71在人类IgA肾病肾组织中的表达强度及与IgA肾病临床病理关系,分析其作为IgA肾病病理和预后标记物的可能性。方法选取该院180例肾穿刺活检为IgA肾病患者,收集患者临床资料,采用光镜、免疫组织化学、免疫荧光、IgA肾病半定量评分等方法检测IgA肾病组肾组织中CD71的表达,并与正常对照组比较;分析CD71与病理严重程度及临床的相关性。结果 (1)在IgA肾病组,CD71的表达明显高于正常对照组(P<0.05),且CD71的表达强度随肾组织病理损害加重而增强;(2)IgA肾病肾组织中CD71表达量与IgA肾病组织学半定量评分法中的系膜细胞增生指数(Ms HI)和系膜基质增多指数(Ms MI)呈正相关(P<0.05);(3)IgA肾病肾组织中CD71的表达量与患者的蛋白尿水平呈正相关,与肌酐清除率水平呈负相关(P<0.05),而与患者血尿水平无明显相关性(P>0.05)。结论 CD71在IgA肾病不同病理肾组织表达不同,随病理损害的加重而增强,且CD71的表达与反应系膜细胞和系膜基质增多指数相关,提示CD71与系膜细胞增殖关系密切;另外,CD71表达量与蛋白尿呈正相关,与肌酐清除率呈负相关,提示其与IgA肾病肾功下降及预后不良有关。因此,肾组织CD71的表达可作为判断该症严重程度和预后的生物学标记物之一。

Objective To investigate the expression of CD71 in renal tissue of humans with IgA nephropathy and the relationship with clinical pathology,and to explore a possible biomarker for diagnosis and prognosis of IgA nephropathy. Methods 180 patients with IgA nephropathy by renal biopsy were collected as the research subjects（ IgA nephropathy group）,and other 18 patients with renal calculi or renal tuberculosis but without IgA nephropathy were taken as the control group. The expressions of CD71 detected by light-microscopy,immunohistochemistry,immunofluorescence and IgA nephropathy semi-quantitative score were compared between the two groups. The relationship of CD71 with both pathologic severity and clinical relevance was analyzed. Results（ 1） The expression of CD71 in the IgA nephropathy group was significantly higher than that in the control group（ P〈0. 05）,and the expression intensity of CD71 was elevated with the aggravation of kidney pathological damage;（ 2） The expressions of CD71 were positively related to mesangial cell proliferation index（ Ms HI） and mesangial matrix increase index（ Ms MI）（ P〈0. 05）;（ 3） The expressions of CD71 were positively related to albuminoria,but negatively related to creatinine clearance rate（ CCR）（ P〈0. 05）,and were not correlated with the levels of hematuria（ P〉0. 05）. Conclusion The expressions of CD71 are different in different pathological renal tissues of IgA nephropathy,which are elevated with the increase of pathological damage,and are positively related to Ms HI and Ms MI. In addition,the expressions of CD71 are negatively related to CCR,and positively related to albuminuria,suggesting that CD71 is relevant to the decline in renal function and prognosis. The expression of CD71 may be one of the biological markers to judge the severity and prognosis of IgA nephropathy.