DNA倍体分析及Ki-67检测对肾实质小肿瘤性质和意义的探讨  

DNA ploidy analysis and Ki-67 examination on renal neoplasms:investigation of degree of malignancy and biological behavior of small renal tumors

作　　者：刘丽娜[1] 张长淮[1] 

机构地区：[1]北京友谊医院病理科,100050

出　　处：《中华病理学杂志》2001年第1期39-42,共4页Chinese Journal of Pathology

摘　　要：目的　探讨肾实质小肿瘤的性质及其生物学行为 ,为临床进一步治疗和预后判断提供病理学依据。方法　应用流式细胞术和免疫组织化学方法 ,对 48个直径≤ 3cm的小肿瘤和 39个直径 >3cm的大肾癌的DNA倍体形式及Ki 6 7增殖状态进行了比较研究。结果　 48个小肿瘤中 ,6个腺瘤均为二倍体 ,Ki 6 7增殖指数 (PR)均 <1%。 42个透明、颗粒细胞型小肿瘤异倍体出现率为16 7% ,与 39例大肾癌的 33.3%差异无统计学意义 ;42个小肿瘤总Ki 6 7PR均数明显低于大肾癌。DNA倍体形式与分级、分期、组织类型相关。Ki 6 7PR与分级相关。结论　小肿瘤中既有腺瘤也有腺癌 ,肿瘤大小不能作为区分它们的标准。DNA倍体及Ki 6 7PR可作为肾实质肿瘤生物学行为和预后判断的重要指标。Objective To investigate the degree of malignancy and the biological behavior of small renal tumors and provide a pathological basis for clinicians in determination of further treatment and prognosis. Methods Flow cytometry and immunohistochemical studies were performed on 48 small tumors with diameters less than 3 cm. and 39 renal cell carcinomas with diameters larger than 3 cm in comparison to assess their DNA ploidy status and Ki 67 PR (proliferation rate). Results Of the 48 small renal tumors, 6 adenoma were all diploid with low PR (<1%). Aneuploid rate of 42 small renal tumors with clear and granular cell type was 16.7%, showing no statistical difference with the 33.3% aneuploid rate of 39 large renal cell carcinomas. 42 small renal tumors had a lower mean PR than large renal cell carcinoma. DNA ploidy correlated closely with nuclear grade, stage and histological type. There existed a close relation between PR and grade. Conclusion Small renal tumors consist of both adenoma and carcinoma, therefore tumor size can not be used as a criterion in their differential diagnosis. DNA ploidy and Ki 67 PR are important indicators for predicting the biological behavior and prognosis of renal parenchymal tumors.

关 键 词：KI-67抗原 流式细胞术 肾实质小肿瘤 DNA倍体 

分 类 号：R737.11[医药卫生—肿瘤] R730.23[医药卫生—临床医学]