增殖细胞核抗原在原发性肾病综合征患儿肾组织的表达

目的 探讨肾病综合征(NS)患儿肾组织增殖细胞核抗原(PCNA)的表达水平及其与肾脏固有细胞增生间的关系。方法 以39例原发性NS患儿肾活检石蜡包埋肾组织及6例肾肿瘤肾切除患者正常肾组织为研究对象，用免疫组织化学方法检测PCIA在肾组织的表达水平，并与NS患儿的病理类型、肾组织病理学积分及肾活检的临床参数进行比较。结果 NS组肾小球和肾小管一间质内PCNA阳性细胞百分率均明显高于对照组，且不同病理类型NS患儿的肾小球内PCNA阳性细胞百分率存在显著差异。肾小球和肾小管一间质内P(NA阳性细胞百分率分别与肾小球和肾小管一间质的病理积分呈正相关，肾小球内PCNA阳性细胞百分率与血清胆固醇呈正相关，肾小管一间质内PCNA阳性细胞百分率与24h尿蛋白量呈正相关。结论 NS患儿肾组织PCNA表达水平增加促进肾脏固有细胞的异常增生，PCNA是判断原发性NS肾脏组织损伤程度和预后的敏感指标。

Expression of proliferating cell nuclear antigen in renal tissues of children with primary nephrotic syndrome

Objective To investigate the expression of proliferating cell nuclear antigen(PCNA) in renal tissues of children with primary nephrotic syndrome(NS),and elucidate the relationship between PCNA expression and cell proliferation in renal tissues from the children with primary NS.Methods Paraffin-embedded renal biopsy tissue sections from 39 patients with primary NS were examined by immunohistochemical staining with anti-PCNA monoclonal antibody,normal renal tissue sections from 6 nephrectomized patients with nephroma were selected as control. Possible correlation between the percentage of PCNA positive cells and the pathologic type , histopathological score, clinical indices (serum albumin ,serum cholesterol ,serum creatinine and 24 hours urine protein ) before renal biopsy of NS were evaluated separately .Results The percentage of PCNA positive cells in glomeruli and tubulom terstitium of NS patients was significantly higher than that of the control (P<0.05);The percentage of PCNA positive cells in glomeruli or tubulointerstitium of NS patients was positively correlated with the histopathological score of glomeruli or tubulointerstitium separately, the correlation coefficient were 0.7482(P<0.001) and 0.6502(P<0.01);the percentage of PCNA positive cells in glomeruli was positively correlated with the serum cholesterol level of NS patients before biopsy, the correlation coefficient was 0.5713(P<0.05 );the percentage of PCNA positive cells in tubulointerstitium was positively correlated with the amount of 24 hours urine protein of NS patients before biopsy, the correlation coefficient was 0.6625(P<0.05).Conclusions The overexpression of PCNA in renal tissues from the children with primary NS can nhance cell proliferation in renal tissues,and PCNA is a sensitive index in judging the pathological injury degree and prognosis of primary NS. J Appl Clin Pediatr,2004,19(5):369-371