TFE3和Cath-K诊断Xp11.2易位性肾癌的价值  

The value of TFE3 and cathepsin K in diagnosis of Xp11. 2 translocation renal cell carcinoma

作　　者：黄道光[1] 陈显成[1] 甘卫东[1] 李笑弓[1] 张古田[1] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,江苏南京210008

出　　处：《中华全科医学》2016年第5期702-704,776,共4页Chinese Journal of General Practice

基　　金：江苏省自然科学基金(BK20131281);国家自然科学基金(81572512)

摘　　要：目的观察转录因子E3(transcription factor E3,TFE3)及组织蛋白酶K(cathepsin-k,Cath-K)在Xp11.2易位/TFE3基因融合相关性肾癌(Xp11.2易位性肾癌)中的表达。方法对2006年1月—2013年3月在南京大学医学院附属鼓楼医院诊断的年龄小于45岁或组织病理形态怀疑Xp11.2易位性肾癌的65例肾细胞癌蜡块标本行TFE3、Cath-K免疫组化试验及荧光原位杂交(fluorescence in situ hybridization,FISH)检测。以FISH阳性作为诊断Xp11.2易位性肾癌的标准,分析TFE3和Cath-K在诊断Xp11.2易位性肾癌中的敏感性、特异性、阳性预测值和阴性预测值。结果 TFE3和Cath-K诊断Xp11.2易位性肾癌的敏感性分别为95.5%和72.7%,特异性分别为93.0%和100.0%,阳性预测值分别为87.5%和100.0%,阴性预测值分别为97.6%和87.8%。TFE3联合Cath-K诊断Xp11.2易位性肾癌的敏感性为94.1%,特异性为100.0%,阳性预测值为100.0%,阴性预测值为98.0%。结论年龄、血尿及组织病理形态仍是提示诊断Xp11.2易位性肾癌的指标之一。TFE3诊断Xp11.2易位性肾癌具有较高的敏感性和阴性预测值,Cath-K具有较高的特异性和阳性预测值。联合TFE3及Cath-K能提高Xp11.2易位性肾癌诊断的准确性。Objective To observe the expression of transcription factor E3 （TFE3） and cathepsin K（Cath-K） in Xp11.2 translocation renal cell carcinoma. Methods Sixty-five cases renal cell carcinoma paraffin block specimens were collected from January 2006 to March 2013 at the Affiliated Drum Tower Hospital of Nanjing University Medical School that less than 45 years or pathology suspected Xp11. 2 translocation renal cell carcinoma,TFE3 and Cath-K immunohistochemistry and fluorescence in situ hybridization （FISH） were detected. FISH positive was used to be diagnosis criteria of Xp11.2 translocation renal cell carcinoma, and to analyze TFE3 and Catb-K sensitivity, specificity, positive predictive value and negative predictive value in the diagnosis of Xp11.2 transloeation renal cell carcinoma. Results TFE3 and Cath-K diagnosis Xp11.2 translocation renal cell carcinoma sensitivity were 95.5% and 72.7% , the specificity were 93.0% and 100% ,the positive predictive value were 87.5% and 100% ,negative predictive value were 97.6% and 87.8%. United TFE3 and Cath-K diagnosis Xp11.2 translocation renal cell carcinoma sensitivity was 94.1% ,specificity was 100% ,positive predictive value was 100% , negative predictive value was 98.0%. Conclusions Age, hematuria and tissue morphology remains were one of the indicators in diagnosis of Xp11.2 translocation renal cell carcinoma. TFE3 with a high sensitivity and negative predictive value, Cath-K with a high specificity and positive predictive value in diagnosis of Xp11.2 translocation renal cell carcinoma. Combined TFE3 and Cath-K can improve the accuracy diagnosis of Xp11.2 translocation renal cell carcinoma.

关 键 词：癌 肾细胞 易位 Xp11.2基因 组织蛋白酶K 转录因子E3 原位杂交 荧光 

分 类 号：R737.11[医药卫生—肿瘤] R730.43[医药卫生—临床医学]