上皮细胞膜抗原和增殖细胞抗原在肾细胞癌中的表达与预后的关系  

Expression of epithelial membrane antigen and proliferating cell nuclear antigen and their relationship with prognosis in renal cell carcinoma by tissue microarray

作　　者：章华元[1] 周涛[1] 尹冬青[1] 朱伟君[1] 

机构地区：[1]台州市立医院病理科,浙江台州318000

出　　处：《全科医学临床与教育》2011年第4期404-406,共3页Clinical Education of General Practice

摘　　要：目的探讨上皮细胞膜抗原(EMA)及增殖细胞抗原(PCNA)在肾细胞癌中的表达与鉴别方法。方法使用免疫组化法检测82例肾细胞癌EMA和PCNA表达,以及比较EMA与PCNA的阳性表达与肾癌临床病理之间的关系。结果 EMA在肾癌中的表达率为75.60%(62/82),主要位于细胞浆与细胞膜。EMA阳性表达组的5年生存率为71.42%,高于EMA阴性表达组的5年生存率(28.57%),差异有统计学意义(χ2=4.32,P<0.05)。PCNA在肾癌中的总阳性表达率78.05%(64/82),主要位于细胞核,均为增殖活跃表达;其5年生存率为57.14%,低于PCNA阴性表达组的5年生存率72.85%,差异有统计学意义(χ2=3.76,P<0.05)。在不同病理分级的肿瘤组织中,Ⅰ级的EMA阳性表达高于Ⅱ级和Ⅲ级,Ⅱ级的EMA阳性表达高于Ⅲ级,差异均有统计学意义(χ2分别=4.77、9.12、9.98,P均<0.05);Ⅰ级的PCNA增殖活跃程度低于Ⅱ级和Ⅲ级,Ⅱ级的PCNA增殖活跃程度低于Ⅲ级,差异均有统计学意义(χ2分别=3.86、8.42、7.95,P均<0.05)。在不同肿瘤大小、组织学分型、临床分期的肿瘤组织中EMA、PCNA的表达比较,除移动细胞癌与透明细胞癌的EMA阳性表达比较,差异有统计学意义(χ2=16.94,P<0.05)外,余指标之间比较,差异均无统计学意义(χ2分别=0.58、2.39、16.94、0.71、8.04、3.01,P均>0.05)。结论 EMA和PCNA在肾细胞癌中表达可在一定程度上反映肿瘤的恶性程度及预后,可作为鉴别高分期肾癌的依据之一。Objective To explore the distinguish method of EMA and PCNA in the renal cell carcinoma.Methods Detected EMA and PCNA of 82 cases in the renal carcinoma by immunohistochemical method,compared the positive expression between EMA and PCNA,and the relationship with the different pathological type of renal cell carcinoma.Results The positive expression of EMA in the renal cell carcinoma was 75.60%（62/82）,mainly located in the cytoplasm and cytomembrane.The survival rate of 62 cases with positive expression of EMA was 71.42% which was higher than 20 cases with negative expression（28.57%）（χ2=4.32,P〈0.05）.The positive expression of PCNA in the renal cell carcinoma was 78.05%（64/82）,mainly located in the caryon.The survival rate of them was 71.42% which was lower than 18 cases with negative expression（72.85%）（χ2=3.76,P〈0.05）.In the different pathological type of carcinoma,the positive expression of EMA in the typeⅠwere higher than that of the type Ⅱ and Ⅲ,the positive expression of EMA in the typeⅡwere higher than that of the type Ⅲ（χ2=4.77,9.12,9.98,P〈0.05）.The positive expression of PCNA in the typeⅠwere lower than that of the type Ⅱ and Ⅲ,the positive expression of PCNA in the typeⅡwere lower than that of the type Ⅲ（χ2=3.86,8.42,7.95,P〈0.05）.The other comparisons had no statistically significant difference（χ2=0.58,2.39,16.94,0.71,8.04,3.01,P〈0.05）.Conclusions EMA and PCNA would indicate the grade malignancy and the prognosis of renal carcinoma to a certain extent.It would be used to distinguish differentiated carcinoma.

关 键 词：肾细胞癌 上皮细胞膜抗原 增殖细胞抗原 

分 类 号：R737.11[医药卫生—肿瘤]