碳酸酐酶Ⅸ联合TFE3对成人Xp11.2易位性肾癌的诊疗作用

The role of CAⅨcombined with TFE3 in the diagnosis of adult Xp11.2 translocated renal carcinoma

目的研究免疫组织化学方法碳酸酐酶Ⅸ(CAⅨ)联合TFE3在鉴别诊断Xp11.2易位性肾癌中的作用。方法纳入山东第一医科大学第二附属医院及上海交通大学医学院附属仁济医院2013年2月-2017年9月收治的24例成人Xp11.2易位性肾癌及24例成人肾透明细胞癌临床病理资料。所有患者均采用CAⅨ免疫组化染色。采用半定量计数方法,对比两组肾细胞癌中CAⅨ的表达情况。结果24例Xp11.2易位性肾癌患者中CAⅨ阳性者1例,且为弱阳性;24例透明细胞性肾细胞癌患者中CAⅨ阳性者22例,其中强阳性者19例,弱阳性者3例;两者CAⅨ阳性率差异有统计学意义(P<0.01)。CAⅨ在6例TFE3高表达透明细胞性肾细胞癌中全部CAⅨ弥漫强阳性表达。TFE3高表达的透明细胞性肾细胞癌与TFE3高表达的Xp11.2易位性肾癌患者中的CAⅨ阳性率有显著性统计学差异(P<0.01)。结论在日常肾细胞癌诊疗工作中,常规采用免疫组化学CAⅨ联合TFE3有助于筛选透明细胞性肾细胞癌与Xp11.2易位性肾癌。

Objective To explore the role of CAⅨcombined with TFE3 in the differential diagnosis of Xp11.2 translo⁃cated renal cell carcinoma.Methods The clinicopathological data of 24 cases of Xp11.2 translocated renal carcinoma and 24 cases of clear cell renal cell carcinoma(ccRCC)treated during Feb.2013 and Sep.2017 were retrospectively analyzed.All pa⁃tients underwent CAⅨimmunohistochemical staining.The expression of CAⅨin the two groups were compared with semiquan⁃titative counting method.Results In the 24 patients with Xp11.2 translocated renal carcinoma,1 was weakly positive for CAⅨ.Among the 24 ccRCC patients,22 were CAⅨpositive,including 19 positive and 3 weakly positive.CAⅨwas positive in 6 ccRCC cases with high expression of TFE3.T There was significant difference between the two groups(P<0.01).There was significant difference in CAⅨpositive rate between ccRCC cases with high TFE3 expression and Xp11.2 translocation renal cell carcinoma cases with high TFE3 expression(P<0.01).Conclusion In the diagnosis and treatment of renal cell carcinoma,the routine use of immunochemical TFE3 combined with CAⅨcan help screen ccRCC and Xp11.2 translocation renal carci⁃noma,which is worthy of clinical promotion.