凝血相关基因及ATⅢ、FIB、DD在肾透明细胞癌诊断、转移及预后中的临床价值  

Clinical value of coagulation related genes and ATⅢ,FIB,DD in diagnosis,metastasis and prognosis of clear cell renal cell carcinoma

作　　者：戴政 封凯文 周毅彬[1] 阳东荣[1] 薛波新[1] 朱进[1] DAI Zheng;FENG Kaiwen;ZHOU Yibin;YANG Dongrong;XUE Boxin;ZHU Jin(Department of Urology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院泌尿外科,215004

出　　处：《现代泌尿生殖肿瘤杂志》2022年第5期269-274,共6页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：江苏省医学重点人才基金(QNRC2016875)。

摘　　要：目的探讨凝血相关基因及抗凝血酶Ⅲ(ATⅢ)、纤维蛋白原(FIB)、D-二聚体(DD)在肾透明细胞癌(ccRCC)诊断、转移及预后中的临床价值。方法回顾性统计108例ccRCC、100例肾良性肿瘤(包括50例肾囊肿和50例肾错构瘤)患者的ATⅢ、FIB及DD含量,比较这些凝血参数在不同肿瘤患者中的差异。并通过分析肿瘤基因组图谱(TCGA)数据库的凝血相关基因,比较这些基因在ccRCC与正常肾组织中的差异及其对ccRCC预后的影响。结果ccRCC组血浆中FIB和DD含量显著高于肾良性肿瘤组(P<0.01),两组的血浆ATⅢ活性比较差异无统计学意义(P>0.05)。ccRCC转移患者与非转移患者的ATⅢ、FIB和DD差异具有统计学意义(P<0.01)。通过受试者工作特征曲线分析得出DD、FIB和ATⅢ区分肾良恶性肿瘤的曲线下面积分别为0.685、0.630和0.579。TCGA数据库中的ccRCC组织与正常肾组织中F2、F3、F7、F8、ACE、SERPINE1基因表达呈显著性差异(P<0.01),F2、SERPINE1基因高表达患者的总生存期(OS)和疾病特异性生存期(DSS)较低表达患者显著降低(P<0.01),而ACE基因高表达患者的OS和DSS较低表达患者显著升高(P<0.01)。结论凝血因子ATⅢ、DD及FIB可用于ccRCC的鉴别诊断,以及预测ccRCC是否转移;凝血相关基因F2、F3、F7、F8、ACE、SERPINE1在ccRCC的辅助诊断及预后预测中有一定价值。Objective To investigate clinical value of the coagulation-related genes and ATⅢ,FIB,DD in the diagnosis,metastasis and prognosis of clear cell renal cell carcinoma(ccRCC).Methods The contents of ATⅢ,FIB,and DD were tallied retrospectively in 108 patients with ccRCC,100 patients with benign renal tumors(including 50 patients with renal cysts and 50 patients with renal hamartoma),and the differences of these coagulation parameters in different tumor patients were compared.The differences of these genes in ccRCC and normal renal tissues,as well as their impact on ccRCC prognosis,were compared by using TCGA database’s coagulation-related genes.Results Patients with ccRCC had significantly greater levels of plasma FIB and DD than those patients with benign renal tumors(P<0.01),but plasma ATⅢactivity did not show significant difference between the two groups(P>0.05).Between the metastatic group and the non-metastatic group,there were significant differences in ATⅢ,FIB and DD(P<0.01).According to ROC analysis,the AUC of DD,FIB,and ATⅢfor distinguishing benign and malignant renal tumors were 0.685,0.630,and 0.579,respectively.In TCGA database,there were significant differences in the expression of F2,F3,F7,F8,ACE,and SERPINE1 genes between ccRCC tissues and normal kidney tissues(P<0.01).OS and DSS significantly decreased in patients with high expression of F2 and SERPINE1 gene(P<0.01),while OS and DSS significantly increased in patients with high expression of ACE gene(P<0.01).Conclusions Coagulation factors ATⅢ,DD and FIB can be used in the differential diagnosis in ccRCC and can predict the metastasis of patients with ccRCC.Coagulation-related genes F2,F3,F7,F8,ACE and SERPINE1 have certain value in auxiliary diagnosis and predicting prognosis in ccRCC.

关 键 词：肾透明细胞癌 D-二聚体 抗凝血酶Ⅲ 纤维蛋白原 凝血基因 

分 类 号：R737.11[医药卫生—肿瘤]