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1、KAI-1在腎細(xì)胞癌中的表達(dá)及意義作者:張錄芳,潘東亮 彭學(xué)葉,尹哲[摘要]目的研究KAI-1在不同分期、分級、預(yù)后和年齡組腎細(xì)胞癌中的表達(dá),分析其表達(dá)的意義。方法隨訪1991~2000年入院治療并留取病理標(biāo)本的腎癌病例預(yù)后。根據(jù)臨床分期、細(xì)胞分級、年齡、T1-3aN0M0病例是否術(shù)后轉(zhuǎn)移分別將腎癌病例分組,應(yīng)用免疫組織化學(xué)方法檢測腎癌標(biāo)本KAI-1表達(dá),卡方檢驗(yàn)分析KAI-1表達(dá)的差異。結(jié)果30~70歲每十年齡段KAI-1陰性表達(dá)率為34.4%~47.8%,比較低表達(dá)率χ2值為0.54~1.19,P均>0.05,過表達(dá)率χ2值為
2、0.84~1.84,P均>0.05。腎癌TNMⅠ~Ⅳ期KAI-1陰性表達(dá)率為34.2%、25.2%、54.4%和80.0%,Ⅰ、Ⅲ、Ⅳ期間過表達(dá)比較P<0.05。Fuhrman分級Ⅰ~Ⅲ級KAI-1陰性表達(dá)率為33.0%、47.8%、81.4%,Ⅱ和Ⅲ、Ⅰ和Ⅲ級比較χ2值分別為9.11、27.24,P均<0.01。T1-3aN0M0術(shù)后轉(zhuǎn)移組24例和未轉(zhuǎn)移組194例KAI-1陰性表達(dá)率為79.2%、9.8%;兩組低表達(dá)率比較χ2值=64.49,P<0.01;過表達(dá)χ2值=0.02,P>0.05。結(jié)論轉(zhuǎn)移抑制
3、基因KAI-1在腎癌中的表達(dá)與年齡因素?zé)o關(guān)。KAI-1低表達(dá)或表達(dá)缺失率在Ⅲ期、Ⅳ期和FuhrmanⅢ級腎癌中最高。KAI-1基因缺失可能參與了T1-3aN0M0腎癌術(shù)后轉(zhuǎn)移的發(fā)生,檢測KAI-1表達(dá)具有臨床預(yù)后指導(dǎo)價值。10[關(guān)鍵詞]腎細(xì)胞;癌;KAI-1;轉(zhuǎn)移抑制基因ExpressionofmetastasessuppressorgeneKAI-1onrenalcellcarcinomaanditssignificance[Abstract]ObjectiveTostudytheexpressionofmetastasessuppr
4、essorgeneKAI-1onrenalcellcarcinoma(RCC)andanalyzeitssignificance.MethodsThepatientswithRCCundergoingsurgicaloperationsfrom1991to2000werefollowedupandtheirprognoseswerewrittendown.Thenthesepatientsweredividedintodifferentgroupsaccordingtotheirclinicalstages,tumourcellgrad
5、ation,ageofpatientandwhetherpostoperativemetastasisofT1-3aN0M0stagepatientsoccurredornot.TheexpressionofKAI-1onRCClesionsweretestifiedwithimmunohistochemistryandtheoutcomesofexpressionwereanalyzedbyχ2testing.ResultsThedifferencesofKAI-1expressioneverydecadesamongagesof30
6、~70werenotstatisticallysignificant.Nevertheless,thenegativeexpressionratesofKAI-1fromTNMⅠtoⅣstagewere34.2%,25.2%,54.4%and80.0%individually,andthestatisticallysignificantdifferencesofKAI-1overexpressionbetweenⅠandⅢandⅣstage(P<0.05).Thenegativeexpressionbetween10Fuhrman
7、G1andG3,G2andG3werecomparedseparatelyandtheχ2scoreswere9.11,27.24(P<0.01).Twentyfourcaseswithpostoperativemetastasisand194caseswithoutpostoperativemetastasisinpatientsofT1-3aN0M0stagewerefoundoutbyfollow-up.ThelowexpressionrateofKAI-1inmetastasisgroupwashigherthanthat
8、ofnometastasisgroup(P<0.01).ConclusionThereisstatisticallysignificantcorrelationbetweentheexpression