KAI-1在肾细胞癌中表达及意义.doc

KAI-1在肾细胞癌中表达及意义 　 作者：张录芳，潘东亮　彭学叶，尹哲 ［摘要］ 目的 研究KAI-1在不同分期、分级、预后和年龄组肾细胞癌中的表达，分析其表达的意义。方法 随访1991～2000年入院治疗并留取病理标本的肾癌病例预后。根据临床分期、细胞分级、年龄、T1-3aN0M0病例是否术后转移分别将肾癌病例分组，应用免疫组织化学方法检测肾癌标本KAI-1表达，卡方检验分析KAI-1表达的差异。结果 30～70岁每十年龄段KAI-1阴性表达率为34.4%～47.8%，比较低表达率χ2值为0.54～1.19，P均gt;0.05，过表达率χ2值为0.84～1.84，P均gt;0.05。肾癌TNMⅠ～Ⅳ期KAI-1阴性表达率为34.2%、25.2%、54.4%和80.0％，Ⅰ、Ⅲ、Ⅳ期间过表达比较Plt;0.05。Fuhrman分级Ⅰ～Ⅲ级KAI-1阴性表达率为33.0%、47.8%、81.4%，Ⅱ和Ⅲ、Ⅰ和Ⅲ级比较χ2值分别为9.11、27.24，P均lt;0.01。T1-3aN0M0术后转移组24例和未转移组194例KAI-1阴性表达率为79.2％、9.8％；两组低表达率比较χ2值＝64.49，Plt;0.01；过表达χ2值＝0.02，Pgt;0.05。结论 转移抑制基因KAI-1在肾癌中的表达与年龄因素无关。KAI-1低表达或表达缺失率在Ⅲ期、Ⅳ期和Fuhrman Ⅲ级肾癌中最高。KAI-1基因缺失可能参与了T1-3aN0M0肾癌术后转移的发生，检测KAI-1表达具有临床预后指导价值。 ［关键词］ 肾细胞；癌；KAI-1；转移抑制基因 Expression of metastases suppressor gene KAI-1 on renal cell carcinoma and its significance ［Abstract］ Objective To study the expression of metastases suppressor gene KAI-1 on renal cell carcinoma（RCC) and analyze its significance.Methods The patients with RCC undergoing surgical operations from 1991 to 2000 were followed up and their prognoses were written down.Then these patients were divided into different groups according to their clinical stages，tumour cell gradation，age of patient and whether postoperative metastasis of T1-3aN0M0 stage patients occurred or not.The expression of KAI-1 on RCC lesions were testified with immunohistochemistry and the outcomes of expression were analyzed by χ2 testing.Results The differences of KAI-1 expression every decades among ages of 30~70 were not statistically significant.Nevertheless，the negative expression rates of KAI-1 from TNM Ⅰto Ⅳ stage were 34.2%，25.2%，54.4% and 80.0％ individually，and the statistically significant differences of KAI-1 overexpression between Ⅰand Ⅲ and Ⅳ stage（Plt;0.05).The negative expression between Fuhrman G1 and G3，G2 and G3 were compared separately and the χ2 scores were 9.11，27.24（Plt;0.01).Twenty four cases with postoperative metastasis and 194 cases without postoperative metastasis in patients of T1-3aN0M0 stage were foun