血小板反应蛋白1在局灶节段性肾小球硬化伴急性肾小管间质损伤的表达

Expression and significance of thrombospondin-1 in focal segmental glomerulosclerosis with acute renal tubular injury

目的:分析局灶节段性肾小球硬化(FSGS)伴急性肾小管间质损伤患者肾组织中血小板反应蛋白1(TSP-1)及其受体表达的分布和意义,及其与临床病理的相关性。方法:共纳入FSGS伴急性肾小管间质损伤患者56例,通过肾组织免疫组化染色,观察TSP-1及其受体信号调节蛋白α(SIRPα)表达。利用数字病理扫描系统(Aperio)对免疫组化染色结果进行扫描并定量,分析TSP-1表达量与临床指标的关系。根据TSP-1表达阳性率,将FSGS伴急性肾小管间质损伤的患者分为TSP-1表达低组(<10%)和TSP-1表达高组(≥10%),ANOVA分析组间差异。结果:TSP-1表达量与尿视黄醇结合蛋白(RBP)、尿蛋白定量、血清肌酐(SCr)成负相关。TSP-1低表达组20例,TSP-1高表达组36例。TSP-1低表达组尿蛋白定量、SCr、尿RBP升高更明显,两组有显著差异。结论:FSGS伴急性肾小管间质损伤时肾小管TSP-1表达升高,表达阳性率的高低与肾功能损伤程度相关。

Objective:To analyze the expression of thrombospondin-1(TSP-1)and its receptor in renal tissue of focal segmental glomerulosclerosis(FSGS)patients with acute tubular interstitial injury,and to analyze the correlation between the expression of TSP-1 and clinicopathology.Methodology:A total of 56 FSGS patients with acute tubular interstitial injury were included,the expression of TSP-1 and its receptor signal regulatory proteinα(SIRPα)was studied by immunohistochemical staining of renal tissue.Immunohistochemical staining results were scanned and quantified by digital pathological scanning system(Aperio),the relationship between TSP-1 expression and clinical indicators was analyzed.According to the positive rate of TSP-1 expression,FSGS patients with tubular interstitial injury were divided into group with low expression of TSP-1(less than 10%)and group with high expression of TSP-1(be equal or more than 10%),analyzed the differences between two groups by ANOVA.Results:Expression of TSP-1 was negatively correlated with urine retinol binding protein(RBP),urine protein quantitation,serum creatinine.There were 20 cases in the low expression group and 36 cases in the high expression group.The urine protein quantitation,serum creatinine and urine retinol binding protein(RBP)were significantly increased in the group with low TSP-1 expression compared with the group with high TSP-1 expression.Conclusion:The expression of TSP-1 in renal tubules was increased in FSGS with acute tubular interstitial injury.The positive rate of TSP-1 expression was related to renal function.