肾透明细胞癌VHL基因和CD44v6表达及预后价值

目的　探讨vonHippel Lindau(VHL)基因和CD4 4v6与肾透明细胞癌 (CCRCC)分级、分期和预后及两者关系。 方法　采用免疫组化EnVision法检测 5 8例CCRCC标本中VHL基因和CD4 4v6的表达 ,比较两者同Fuhrman分级、病理分期和预后的关系及两者之间的关系。结果　VHL基因表达阳性率为 5 6 9% (33/5 8) ,为胞质染色 ;CD4 4v6表达阳性率为 4 4 8%(2 6 /5 8) ,为细胞膜染色。两者表达与病理核分级 (P <0 0 0 1)和患者生存率 (P <0 0 0 1和P <0 0 1)均相关。与病理分期无关 (P >0 0 5 )。两者相互之间也相关 (P <0 0 0 1)。结论　VHL基因和CD4 4v6表达可能在CCRCC进展中发挥作用 ,并为判断预后提供了有用的信息。

Expression of VHL gene and CD44v6 and their prognostic value in clear cell renal cell carcinoma

Purpose To examine the expression of von Hippel-Lindau(VHL) gene and CD44 isoform v6 (CD44v6) in patients with clear cell renal cell carcinoma (CCRCC) and to assess the association of its expression with Fuhrman grade, pTNM stage and prognostic value, including its relationship with each other. Methods A retrospective analysis of 58 patients was undertaken. These patients had undergone a radical or partial nephrectomy in our hospital between 1989 and 2000. Immunohistochemical staining was performed by the EnVision method using a monoclonal mouse antibody (Ig33 or VEF-7). Staining characteristics were compared with the clinicopathological results. Results Of the 58 primary tumour specimens, immunohistochemistry showed that 33 (56.9%) expressed VHL gene in the cytoplasm and 26 (44.8%) cases expressed CD44v6 in the cell membrane. Statistical analysis showed that VHL gene or CD44v6 expression was significantly correlated with the Fuhrman grade (P<0.001) and not with pTNM stage (P>05). VHL gene expression was also significantly correlated with CD44v6 expression (P<0.001). The prognosis in patients with CCRCC who were VHL gene or CD44v6-positive was worse than that of patients who were VHL gene or CD44v6-negative (P<0.001 and 0.01, respectively). Conclusions VHL gene or CD44v6 may play a role in the progression of CCRCC, and thus the analysis of VHL gene or CD44v6 expression may provide useful prognostic information.