肿瘤和肾周脂肪组织活化蛋白-α用于透明细胞肾细胞癌危险分层的研究  

Clinical study of FAP in tumor and perinephric adipose tissue for risk stratification of clear cell renal cell carcinoma

作　　者：肖梅仙 李洪波 匡黎[1] XIAO Meixian;LI Hongbo;KUANG Li(Department of Oncology,Dongfeng General Hospital of Sinopharm Affiliated to Hubei Medical College,Hubei,Shiyan 442001,China)

机构地区：[1]湖北医药学院附属国药东风总医院肿瘤科,湖北十堰442001

出　　处：《临床外科杂志》2024年第7期748-752,共5页Journal of Clinical Surgery

基　　金：湖北省卫生健康委员会科研计划项目(WJ2019F070)。

摘　　要：目的分析成纤维细胞活化蛋白-α(FAP)在肿瘤组织和肾周脂肪组织中的表达以及用于透明细胞肾细胞癌(ccRCC)危险分层的临床价值。方法对2018年6月~2022年9月湖北医药学院附属国药东风总医院肿瘤科接受肾切除术的ccRCC病人进行回顾性横断面研究。采用免疫组化免疫组化ABC染色法检测ccRCC肾肿瘤组织(114例)、非肿瘤性肾皮质组织(68例)和肾周脂肪组织(60例)中FAP的表达。收集19例良性肾脏疾病病人肾周良性脂肪组织作为对照组,同样检测FAP表达。绘制ROC曲线分析肾周脂肪组织FAP表达对ccRCC诊断和预测远处转移的能力。结果与匹配非肿瘤性肾皮质组织相比,ccRCC组织FAP表达未上调。经受试者工作特征(ROC)曲线分析,ccRCC组织FAP阳性染色百分比具有良好的肿瘤临床分期、肿瘤大小、远处转移潜力(P<0.001),曲线下面积(AUC)分别为0.90(95%CI:0.81~0.98)、0.79(95%CI:0.66~0.92)和0.86(95%CI:0.74~0.99)。而ccRCC肾周脂肪组织FAP阳性染色百分比可预测远处转移,AUC为0.91(95%CI:0.84~0.97)。ccRCC肾周脂肪组织FAP表达染色强度(191.77±3.14 vs.188.90±2.89,P<0.001)略高于良性肾脏疾病,且肾周脂肪组织FAP染色强度对于良恶性肾脏肿瘤具有一定区分价值,AUC为0.68(95%CI:0.60~0.77)。结论肿瘤和肾周脂肪组织FAP都有望成为ccRCC风险分层的有效指标之一。Objective To analyze the typical biomarker of cancer-related fibroblasts-fibroblast activation protein-α(FAP)expression in tumor tissue and perinephric adipose tissue and its clinical value in risk stratification of clear cell renal cell carcinoma(ccRCC).Methods A retrospective cross-sectional study was conducted on ccRCC patients who underwent nephrectomy in Dongfeng General Hospital of Sinopharm Affiliated to Hubei Medical College from June 2018 to September 2022.The expression of FAP in ccRCC renal tumor tissue(n=114),non-neoplastic renal cortex tissue(n=68)and perirenal adipose tissue(n=60)was detected by immunohistochemical staining,and immunohistochemical images were quantitatively analyzed.The benign adipose tissue around the kidneys from 19 patients with benign kidney disease were collected as a control group,and also detect FAP expression.Receiver operating characteristic(ROC)curves was used to analyze the ability of FAP expression in perirenal adipose tissue to diagnose ccRCC and predict distant metastasis.Results Compared with matched non-neoplastic renal tissues,the expression of FAP in ccRCC was not up-regulated.The receiver operating characteristic(ROC)curve analysis showed that the percentage of FAP positive staining in ccRCC tissue had good tumor clinical stage,tumor size and distant metastasis potential(P<0.001),and the area under the curve(AUC)were 0.90(95%CI:0.81-0.98),0.79(95%CI:0.66-0.92)and 0.86(95%CI:0.74-0.99),respectively.The percentage of FAP positive staining in perinephric adipose tissue of ccRCC can predict distant metastasis,and the AUC is 0.91(95%CI:0.84~0.97).The staining intensity of FAP expression in perinephric adipose tissue of ccrcc(191.77±3.14 vs.188.90±2.89,P<0.001)was slightly higher than that of benign renal disease,and the staining intensity of FAP in perinephric adipose tissue had a certain distinguishing value for benign and malignant renal tumors,with AUC of 0.68(95%CI:0.60~0.77).Conclusion FAP in tumor and perinephric adipose tissue is expected to be one of the eff

关 键 词：透明细胞肾细胞癌 成纤维细胞活化蛋白-α 肿瘤侵袭性 肾周脂肪组织 

分 类 号：R737.11[医药卫生—肿瘤]