增殖细胞核抗原在肾孟输尿管癌中的表达及临床意义  

ExpressionandclinicalsignificanceofPCNAinrenalpelvicandureteralcancer

作　　者：孔垂泽[1,2] 李泽良[1,2] 刘同才[1,2] 张铭铮[1,2] 李书章[1,2] 李芳[1,2] 王立忠[1,2] 温强[1,2] 孙志熙[1,2] 任玉鹏[1,2] 徐彪[1,2] 

机构地区：[1]中国医科大学第一临床学院泌尿科 [2]沈阳医学院附属第二医院

出　　处：《中华外科杂志》1996年第10期614-616,共3页Chinese Journal of Surgery

摘　　要：为了探讨ＰＣＮＡ表达与肾盂输尿管癌病理分期、细胞分级、复发及预后的关系，作者采用免疫组化Ｓ－Ｐ法对４７例肾盂输尿管癌ＰＣＮＡ增殖指数进行研究。结果表明：肾盂输尿管癌ＰＣＮＡ增殖指数随病理分期，细胞分级升高而增高，Ｔ３加Ｔ４ＰＣＮＡ增殖指数明显高于Ｔ１加Ｔ２（Ｐ＜０．０１）．ＧＰＣＮＡ增殖指数明显高于Ｇ１加Ｇ２（Ｐ＜０．００１），ＰＣＮＡ增殖指数高者（Ⅲ加Ⅳ级）术后膀胱癌再发率为６０％（１２／２０）明显高于增殖指数低者（Ⅰ加Ⅱ级）２２．２％（６／２７）Ｐ＜０．０１。ＰＣＮＡ增殖指数Ⅲ加Ⅳ级同时伴发尿路上皮多器官癌占３５％（７／２０），Ⅰ加Ⅱ级同时伴发尿路上皮多器官癌占７．４％（２／２７）Ｐ＜０．０５。ＰＣＮＡ增殖指数Ⅰ加Ⅱ级术后局部复发转移率为７．４％〔２／２７），Ⅲ加Ⅳ级局部复发转移率为４０％（８／２０），Ｐ＜０．０５。ＰＣＮＡ增殖指数Ⅰ加Ⅱ级５年生存率为８６．７％（１３／１５），Ⅲ加Ⅳ级５年生存率为３５．７％（５／１４）Ｐ＜０．０５。提示ＰＣＮＡ增殖指数与肾盂输尿管癌的病理分期，细胞分级有关，是低分化、侵袭性以及同时或相继发生尿路上皮多器官癌的重要特征，可能是判断肾盂输尿管癌预后的重要指标。TodeterminetherelationshipbetweenPCNAexpressionandpathologicalstage,cellulargrade,recurrenceandprognosisofrenalpelvicandureteralcancer,researchonPCNAproliferatingindexin47casesofrenalpelvicandureteralcancerwestudiedbyimmunohistochemistryS-Pmethod.PCNAproliferatingindexofrenalpelvicandureteralcancerincreasedwithpathologicstageandcellulargrade.PCNAproliferatingindexofT3+T4wassignificantlyhigherthanthatofT1+T2(P<0.01).PCNApro-liferatingindexofG3wassignificantlyhigherthanthatofG1+G2(P<0.001).ThosewithhigherPCNAproliferatingindex(Ⅲ+Ⅳ)hadhigherbladdercancerreccurentrateafteroperation(60%,12/20),thosewithlowerPCNAproliferatingindex(Ⅰ+Ⅱ)hadlowerbladdercancerrecurrentrate(22.2%,6/*?7).P<0.01.35%(7/20)ofthosewithⅢ+ⅣPCNAproliferatingindexhadsimultaneouspolyorganicurothalialcancer,7.4%* (2/27)ofthosewithⅠ+ⅡPCNAproliferatingindexhadsimultaneouspoly-organicurothelialcancer,P<0.05.7.4%* (2/27)ofthosewithⅠ+ⅡPCNAproliferatingindexhadlocalrecurrenceandmetastasisafteroperation,40%* (8/20)ofthosewithⅢ+ⅣhadlocalrecurrenceandmetastasisP<0.05.The5-yearsurvivalrateofⅠ+Ⅱwas86.7%,the5-yearsurvivalratedofⅢ+Ⅳwas35.7%* (5/14),P<0.05.ThefindingssuggestthatPCNAproliferatingindexconnectswithpatho-logicalstageandcellulargradeofrenalpelvicandureteralcancer.Itisanimportantcharacteristicoflowdifferentiation,invasivenessandsimultaneousorsequentiallypolyorganicurothelialcancer.Itmaybeanimportantprognosticindicatorofrenalpelvicandureteralcancer.

关 键 词：肾肿瘤 输尿管肿瘤 癌 增殖细胞核抗原 

分 类 号：R737.11[医药卫生—肿瘤] R737.13[医药卫生—临床医学]